Preoperative lymphocyte percentage and neutrophil-lymphocyte ratio are useful predictors of 30-day postoperative complications after lumbar fusion

Temidayo Osunronbi; Balint Borbas; Hiba Lusta; Agbolahan Sofela; Himanshu Sharma

doi:10.25259/SNI_160_2022

Preoperative lymphocyte percentage and neutrophil-lymphocyte ratio are useful predictors of 30-day postoperative complications after lumbar fusion

Surg Neurol Int. 2022 Apr 15:13:145. doi: 10.25259/SNI_160_2022. eCollection 2022.

Authors

Temidayo Osunronbi^#^{1

2}, Balint Borbas^#³, Hiba Lusta³, Agbolahan Sofela⁴, Himanshu Sharma⁴

Affiliations

¹ Department of Surgery, Hull University Teaching Hospitals NHS Trust, Anlaby Road, Hull.
² Department of Health Sciences, University of York, York.
³ Peninsula Medical School, Faculty of Health, University of Plymouth, Plymouth Science Park, Plymouth.
⁴ Southwest Neurosurgery Centre, University Hospitals Plymouth NHS Trust, Plymouth, United Kingdom.

^# Contributed equally.

Abstract

Background: Lymphocyte percentage/count, platelet-lymphocyte ratio (PLR), and neutrophil-lymphocyte ratio (NLR) have shown prognostic significance in patients with cancer, stroke, and following cardiac surgery. However, the utility of these blood parameters for assessing the 30-day postoperative risk for lumbar fusion complications has not been established.

Methods: In this single-center-single-surgeon retrospective series, 77 consecutive patients underwent one- or two-level lumbar fusion. Lymphocyte percentage/count, PLR, and NLR were investigated as predictors of 30-day postoperative complications.

Results: Ten of 77 patients had postoperative complications. A unit increase in NLR and lymphocyte percentage was significantly associated with a 23% increase and 7% decrease, respectively, in the odds of a complication occurring. Preoperative NLR ≥ 2.32 and lymphocyte percentage ≤ 29.5% significantly discriminated between the "complication" and "no-complication" groups.

Conclusion: Patients with a preoperative lymphocyte percentage of ≤29.5% and/or NLR ≥2.32 should be closely monitored as high-risk groups susceptible to 30-day postoperative complications after lumbar fusion.

Keywords: Complications; Lymphocyte; Neutrophil; Prognosis; Spinal fusion.