Department of Orthopaedics, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.
J Orthop Surg (Hong Kong). 2020 Jan-Apr;28(2):2309499020918402. doi: 10.1177/2309499020918402.
Although the neutrophil-lymphocyte ratio (NLR) is a simple biomarker for inflammation, its diagnostic value for predicting surgical site infection (SSI) after spinal decompression surgery has not been extensively investigated. We aimed to determine the predictive value of NLR for SSI in patients undergoing spinal decompression surgery.
We performed a retrospective observational study of patients who underwent spinal decompression surgery. Consecutive 254 patients were divided into an SSI group and a non-SSI group based on the presence of SSI. We evaluated which markers, including NLR, differed significantly between groups. We then determined the diagnostic cutoff values of these markers for the prediction of SSI based on the significance in the univariate analysis.
The incidence of SSI was 7 of 254 patients (2.8%). Univariate analysis showed that there were significant differences in the C-reactive protein (CRP) level at 1 day postoperatively; neutrophil and lymphocyte percentage and NLR at 3-4 days postoperatively; and CRP level, white blood cell count, neutrophil count and percentage, lymphocyte percentage, and NLR at 6-7 days postoperatively between SSI and non-SSI groups. Among these markers, the cutoff values of lymphocyte percentage and NLR at 3-4 days postoperatively for the prediction of SSI were ≤15.1% and ≥4.91, respectively. The cutoff values of lymphocyte percentage and NLR at 6-7 days postoperatively were ≤19.8% and ≥3.21, respectively.
Lymphocyte percentage and NLR at 3-4 and 6-7 days postoperatively were useful markers for the early prediction of SSI in patients who had undergone spinal decompression surgery. These parameters may aid in identifying patients at higher risk of SSI after spinal decompression surgery.
虽然中性粒细胞与淋巴细胞比值（NLR）是炎症的一个简单生物标志物，但它对预测脊柱减压手术后手术部位感染（SSI）的诊断价值尚未得到广泛研究。我们旨在确定 NLR 对接受脊柱减压手术患者 SSI 的预测价值。
我们对接受脊柱减压手术的患者进行了回顾性观察性研究。根据是否发生 SSI，将连续 254 例患者分为 SSI 组和非 SSI 组。我们评估了包括 NLR 在内的哪些标志物在两组之间有显著差异。然后，我们根据单因素分析的显著性确定这些标志物预测 SSI 的诊断截断值。
254 例患者中 SSI 的发生率为 7 例（2.8%）。单因素分析显示，术后 1 天的 C 反应蛋白（CRP）水平；术后 3-4 天的中性粒细胞和淋巴细胞百分比和 NLR；以及术后 6-7 天的 CRP 水平、白细胞计数、中性粒细胞计数和百分比、淋巴细胞百分比和 NLR 之间存在显著差异。在这些标志物中，术后 3-4 天预测 SSI 的淋巴细胞百分比和 NLR 的截断值分别为≤15.1%和≥4.91。术后 6-7 天预测 SSI 的淋巴细胞百分比和 NLR 的截断值分别为≤19.8%和≥3.21。
术后 3-4 天和 6-7 天的淋巴细胞百分比和 NLR 是预测脊柱减压手术后患者 SSI 的有用标志物。这些参数可能有助于识别脊柱减压手术后 SSI 风险较高的患者。
