Raguž Marina, Tarle Marko, Marčinković Petar, Chudy Hana, Orešković Darko, Vuletić Vladimira, Marinović Tonko, Chudy Darko
Department of Neurosurgery, Dubrava University Hospital, 10000 Zagreb, Croatia.
School of Medicine, Catholic University of Croatia, 10000 Zagreb, Croatia.
J Clin Med. 2025 May 29;14(11):3811. doi: 10.3390/jcm14113811.
: Parkinson's disease (PD) is a progressive neurodegenerative disorder associated with systemic inflammation, immune dysregulation, and malnutrition, all of which may influence surgical outcomes. Subthalamic nucleus deep brain stimulation (STN DBS) is a widely used treatment for advanced PD, yet postoperative complications remain a concern. This study evaluates the predictive value of preoperative immunonutritional markers-including the Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score, Aggregate Index of Systemic Inflammation (AISI), Lymphocyte-to-Monocyte Ratio (LMR), and systemic inflammatory response syndrome (SIRS)-for the risk of extracranial complications following STN DBS. : A retrospective cohort study was conducted on 138 PD patients who underwent STN DBS. Clinical and laboratory data were analyzed to assess the association between preoperative immunonutritional markers and postoperative complications, including infections, wound healing disturbances, and surgical revisions. Logistic regression and receiver operating characteristic (ROC) analysis were performed to evaluate the predictive power of these markers. : SIRS emerged as the strongest predictor of complications (aOR = 6.99, 95% CI = 1.844-26.509), emphasizing the critical role of systemic inflammation in surgical outcomes. HALP, AISI, and LMR also demonstrated significant predictive potential, with HALP (AUC = 0.69) and LMR (AUC = 0.73) being the most robust predictors of complications. While albumin alone was not a significant predictor, it correlated with inflammatory markers and comorbidities, underscoring its role in broader risk assessments. : This study underscores the value of preoperative immunonutritional markers in predicting complications following STN DBS in PD patients. Incorporating these markers into clinical risk stratification may enhance preoperative planning and personalized postoperative care, ultimately improving surgical outcomes. These findings, while promising, warrant validation through prospective, multicenter studies to refine predictive models and enhance patient outcomes.
帕金森病（PD）是一种进行性神经退行性疾病，与全身炎症、免疫失调和营养不良相关，所有这些因素都可能影响手术结果。丘脑底核深部脑刺激（STN DBS）是晚期PD广泛使用的治疗方法，但术后并发症仍是一个令人担忧的问题。本研究评估术前免疫营养标志物——包括血红蛋白、白蛋白、淋巴细胞和血小板（HALP）评分、全身炎症综合指数（AISI）、淋巴细胞与单核细胞比值（LMR）和全身炎症反应综合征（SIRS）——对STN DBS术后颅外并发症风险的预测价值。
对138例接受STN DBS的PD患者进行了一项回顾性队列研究。分析临床和实验室数据，以评估术前免疫营养标志物与术后并发症之间的关联，包括感染、伤口愈合障碍和手术翻修。进行逻辑回归和受试者工作特征（ROC）分析，以评估这些标志物的预测能力。
SIRS是并发症最强的预测指标（调整后比值比[aOR]=6.99，95%置信区间[CI]=1.844-26.509），强调全身炎症在手术结果中的关键作用。HALP、AISI和LMR也显示出显著的预测潜力，其中HALP（曲线下面积[AUC]=0.69）和LMR（AUC=0.73）是并发症最有力的预测指标。虽然单独的白蛋白不是一个显著的预测指标，但它与炎症标志物和合并症相关，强调了其在更广泛风险评估中的作用。
本研究强调了术前免疫营养标志物在预测PD患者STN DBS术后并发症方面的价值。将这些标志物纳入临床风险分层可能会加强术前规划和个性化术后护理，最终改善手术结果。这些发现虽然很有前景，但需要通过前瞻性、多中心研究进行验证，以完善预测模型并改善患者预后。
