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The Significance of Preoperative Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Systemic Inflammatory Index (SII) in Predicting Severity and Adverse Outcomes in Acute Calculous Cholecystitis
The prediction of severity in acute calculous cholecystitis (AC) is important in therapeutic management to ensure an early recovery and prevent adverse postoperative events. We analyzed the value of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic inflammato...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10648653/ https://www.ncbi.nlm.nih.gov/pubmed/37959411 http://dx.doi.org/10.3390/jcm12216946 |
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author | Serban, Dragos Stoica, Paul Lorin Dascalu, Ana Maria Bratu, Dan Georgian Cristea, Bogdan Mihai Alius, Catalin Motofei, Ion Tudor, Corneliu Tribus, Laura Carina Serboiu, Crenguta Tudosie, Mihail Silviu Tanasescu, Denisa Vancea, Geta Costea, Daniel Ovidiu |
author_facet | Serban, Dragos Stoica, Paul Lorin Dascalu, Ana Maria Bratu, Dan Georgian Cristea, Bogdan Mihai Alius, Catalin Motofei, Ion Tudor, Corneliu Tribus, Laura Carina Serboiu, Crenguta Tudosie, Mihail Silviu Tanasescu, Denisa Vancea, Geta Costea, Daniel Ovidiu |
author_sort | Serban, Dragos |
collection | PubMed |
description | The prediction of severity in acute calculous cholecystitis (AC) is important in therapeutic management to ensure an early recovery and prevent adverse postoperative events. We analyzed the value of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic inflammatory index (SII) to predict advanced inflammation, the risk for conversion, and postoperative complications in AC. Advanced AC was considered the cases with empyema, gangrene, perforation of the gallbladder, abscesses, or difficulties in achieving the critical view of safety. A 3-year retrospective was performed on 235 patients admitted in emergency care for AC. The NLR was superior to the PLR and SII in predicting advanced inflammation and risk for conversion. The best predictive value was found to be at an NLR “cut-off” value of >4.19, with a sensitivity of 85.5% and a specificity of 66.9% (AUC = 0.824). The NLR, SII, and TG 13/18 correlate well with postoperative complications of Clavien–Dindo grade IV (p < 0.001 for all variables) and sepsis. For predicting early postoperative sepsis, TG 13/18 grading >2 and NLR > 8.54 show the best predicting power (AUC = 0.931; AUC = 0.888, respectively), although not significantly higher than that of the PLR and SII. The NLR is a useful biomarker in assessing the severity of inflammation in AC. The SII and PLR may be useful in the prediction of systemic inflammatory response. |
format | Online Article Text |
id | pubmed-10648653 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-106486532023-11-06 The Significance of Preoperative Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Systemic Inflammatory Index (SII) in Predicting Severity and Adverse Outcomes in Acute Calculous Cholecystitis Serban, Dragos Stoica, Paul Lorin Dascalu, Ana Maria Bratu, Dan Georgian Cristea, Bogdan Mihai Alius, Catalin Motofei, Ion Tudor, Corneliu Tribus, Laura Carina Serboiu, Crenguta Tudosie, Mihail Silviu Tanasescu, Denisa Vancea, Geta Costea, Daniel Ovidiu J Clin Med Article The prediction of severity in acute calculous cholecystitis (AC) is important in therapeutic management to ensure an early recovery and prevent adverse postoperative events. We analyzed the value of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic inflammatory index (SII) to predict advanced inflammation, the risk for conversion, and postoperative complications in AC. Advanced AC was considered the cases with empyema, gangrene, perforation of the gallbladder, abscesses, or difficulties in achieving the critical view of safety. A 3-year retrospective was performed on 235 patients admitted in emergency care for AC. The NLR was superior to the PLR and SII in predicting advanced inflammation and risk for conversion. The best predictive value was found to be at an NLR “cut-off” value of >4.19, with a sensitivity of 85.5% and a specificity of 66.9% (AUC = 0.824). The NLR, SII, and TG 13/18 correlate well with postoperative complications of Clavien–Dindo grade IV (p < 0.001 for all variables) and sepsis. For predicting early postoperative sepsis, TG 13/18 grading >2 and NLR > 8.54 show the best predicting power (AUC = 0.931; AUC = 0.888, respectively), although not significantly higher than that of the PLR and SII. The NLR is a useful biomarker in assessing the severity of inflammation in AC. The SII and PLR may be useful in the prediction of systemic inflammatory response. MDPI 2023-11-06 /pmc/articles/PMC10648653/ /pubmed/37959411 http://dx.doi.org/10.3390/jcm12216946 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Serban, Dragos Stoica, Paul Lorin Dascalu, Ana Maria Bratu, Dan Georgian Cristea, Bogdan Mihai Alius, Catalin Motofei, Ion Tudor, Corneliu Tribus, Laura Carina Serboiu, Crenguta Tudosie, Mihail Silviu Tanasescu, Denisa Vancea, Geta Costea, Daniel Ovidiu The Significance of Preoperative Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Systemic Inflammatory Index (SII) in Predicting Severity and Adverse Outcomes in Acute Calculous Cholecystitis |
title | The Significance of Preoperative Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Systemic Inflammatory Index (SII) in Predicting Severity and Adverse Outcomes in Acute Calculous Cholecystitis |
title_full | The Significance of Preoperative Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Systemic Inflammatory Index (SII) in Predicting Severity and Adverse Outcomes in Acute Calculous Cholecystitis |
title_fullStr | The Significance of Preoperative Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Systemic Inflammatory Index (SII) in Predicting Severity and Adverse Outcomes in Acute Calculous Cholecystitis |
title_full_unstemmed | The Significance of Preoperative Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Systemic Inflammatory Index (SII) in Predicting Severity and Adverse Outcomes in Acute Calculous Cholecystitis |
title_short | The Significance of Preoperative Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Systemic Inflammatory Index (SII) in Predicting Severity and Adverse Outcomes in Acute Calculous Cholecystitis |
title_sort | significance of preoperative neutrophil-to-lymphocyte ratio (nlr), platelet-to-lymphocyte ratio (plr), and systemic inflammatory index (sii) in predicting severity and adverse outcomes in acute calculous cholecystitis |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10648653/ https://www.ncbi.nlm.nih.gov/pubmed/37959411 http://dx.doi.org/10.3390/jcm12216946 |
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