Predictive value of preoperative neutrophil to lymphocyte ratio and platelet to lymphocyte ratio combined with operating room factors for surgical site infection after laparoscopic radical nephrectomy in renal cell carcinoma patients

Abstract

BackgroundSurgical site infections (SSIs) can pose significant risks to patients undergoing surgical procedures. This study aimed to investigate the risk factors and diagnostic value of neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) for SSIs in patients undergoing laparoscopic radical nephrectomy for renal cell carcinoma.MethodsA retrospective analysis of 866 patients at our hospital was conducted between June 2016 and June 2022. The study divided patients into two groups: those with SSIs and those without. General data and operative room‐related information were collected. Inclusion and exclusion criteria were clearly defined. Peripheral blood indicators were analysed, and observation indicators were meticulously selected, including surgery time, usage of a laminar flow operating room and intraoperative hypothermia. Statistical analysis was performed using SPSS 25.0 software, including univariate, multivariate analysis and receiver operating characteristic (ROC) curve analysis.ResultsThirty‐six out of 866 patients developed SSIs. Statistically significant differences were found for surgery time, usage of non‐laminar flow operating rooms and intraoperative hypothermia (p < 0.05). ROC curve analysis showed an AUC of 0.765 (95% CI: 0.636–0.868) for serum NLR and PLR, with optimal cut‐off values at NLR 4.8 and PLR 196, indicating moderate to strong discriminative ability for SSIs.ConclusionsThe study identified non‐laminar flow operating rooms, extended surgery time, and intraoperative hypothermia as significant risk factors for SSIs. Serum NLR and PLR were found valuable as biomarkers for SSIs diagnosis, holding potential for preoperative risk assessment and improved patient safety in renal cell carcinoma care.

Analysis of pathogen distribution and associated risk factors for surgical site infections following laparoscopic urological surgeries

“…Nevertheless, the occurrence of SSIs remains a non‐negligible complication that can significantly impact patient outcomes. Our research advocates for an integrative risk management approach, incorporating both operative and patient‐specific factors, to mitigate the incidence of postoperative infections effectively 19,20 . The onset of wound infections post‐laparoscopy can necessitate additional medical interventions such as debridement, secondary suturing and even extensive procedures to eradicate deep infections in the retroperitoneal space 21 .…”

“…Our research advocates for an integrative risk management approach, incorporating both operative and patient‐specific factors, to mitigate the incidence of postoperative infections effectively. 19 , 20 The onset of wound infections post‐laparoscopy can necessitate additional medical interventions such as debridement, secondary suturing and even extensive procedures to eradicate deep infections in the retroperitoneal space. 21 In severe cases, multiple abscess drainages may be required, which underscores the clinical and economic importance of understanding and mitigating the risk factors for SSIs.…”