Association between Preoperative Neutrophil-lymphocyte Ratio and All-cause Mortality in Patients Treated with Thoracic Endovascular Aortic Repair for Degenerative Thoracic Aortic Aneurysm.

BACKGROUND

The neutrophil-lymphocyte ratio (NLR) has been increasingly recognized as a reliable surrogate marker for predicting mortality in clinical practice. This study determined the predictive ability of NLR for overall mortality after thoracic endovascular aortic repair (TEVAR) for degenerative thoracic aortic aneurysm (TAA).

METHODS

Data from patients treated with TEVAR for degenerative TAA at our university hospital from January 2013 to December 2021 were evaluated. The preoperative NLR was calculated by dividing the absolute neutrophil count by the absolute lymphocyte count.

RESULTS

One hundred-three patients were included in this study. During a 9-year follow-up, 32 patients (31.1%) died. Multivariable analyses showed that age (hazard ratio [HR], 1.06; 95% confidence interval [CI], 1.00-1.12; P = 0.021), ischemic heart disease (HR, 2.13; 95% CI, 1.05-4.36; P = 0.038), and NLR (HR, 1.36; 95% CI, 1.08-1.72; P = 0.009) predicted all-cause mortality after TEVAR. A receiver operating characteristic curve determined the optimal cutoff value of NLR to predict all-cause mortality was 3.48.

CONCLUSIONS

An elevated preoperative NLR is indicative of a higher likelihood of all-cause mortality in patients treated with TEVAR for degenerative TAA, suggesting that NLR could serve as a possible biomarker for stratifying patients at risk of overall mortality after TEVAR.