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Surgical Endoscopy

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01-06-2017

Postoperative day one neutrophil-to-lymphocyte ratio as a predictor of 30-day outcomes in bariatric surgery patients

Authors: Matthew Da Silva, Michelle C. Cleghorn, Ahmad Elnahas, Timothy D. Jackson, Allan Okrainec, Fayez A. Quereshy

Published in: Surgical Endoscopy | Issue 6/2017

Abstract

Background

The neutrophil-to-lymphocyte ratio (NLR) is a marker that reflects systemic inflammation and organ dysfunction. Its use as a prognostic marker to predict complications following surgery has been recently described in the literature.

Objectives

The objective of our study was to evaluate the use of postoperative day one (POD1) NLR as a predictor of 30-day outcomes in patients undergoing bariatric surgery.

Setting

University Hospital.

Methods

We performed a retrospective chart review of 789 patients who underwent bariatric surgery at our institution between March 2012 and May 2014. Data were collected from electronic patient records and administrative databases used for quality improvement. POD1 NLR values were obtained from complete blood counts along with a variety of 30-day clinical outcomes. Univariate and multivariable analyses were conducted to determine whether POD1 NLR ≥10 was associated with 30-day outcomes.

Results

Seven-hundred and thirty-seven patients were included in the study. Six-hundred and fifty-three Roux-en-Y gastric bypass surgeries (88.6 %) and 84 sleeve gastrectomy surgeries (11.4 %) were performed. All surgeries were performed laparoscopically. We observed a 4.7 % readmission rate, 2.2 % reoperation rate, 10.7 % postoperative occurrence rate, and 0.1 % mortality rate. After covariate adjustment, POD1 NLR ≥10 was found to be significantly associated with overall complications (OR 1.98, 95 % CI 1.01–3.87), major complications (OR 3.71, 95 % CI 1.76–7.82), reoperation (OR 3.63, 95 % CI 1.14–11.6), and prolonged postoperative length of stay (OR 3.70, 95 % CI 2.2–6.22).

Conclusion

POD1 NLR was independently associated with 30-day outcomes following bariatric surgery. This easily obtained inflammatory marker may be used to help identify patients at a higher risk of developing early complications.

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Title: Postoperative day one neutrophil-to-lymphocyte ratio as a predictor of 30-day outcomes in bariatric surgery patients
Authors: Matthew Da Silva
Michelle C. Cleghorn
Ahmad Elnahas
Timothy D. Jackson
Allan Okrainec
Fayez A. Quereshy
Publication date: 01-06-2017
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 6/2017
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-016-5278-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Postoperative day one neutrophil-to-lymphocyte ratio as a predictor of 30-day outcomes in bariatric surgery patients

Abstract

Background

Objectives

Setting

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Objectives

Setting

Methods

Results

Conclusion

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