P. Bou-Samra1, M. Axline1, C. Shen1, A. Tsung1 1University Of Pittsburg,Hepatobiliary And Pancreatic Surgery,Pittsburgh, PA, USA
Introduction: Post-operative complications and the surgical stress are inductive to inflammation, that has been shown to affect outcomes. The Neutrophil-Lymphocyte Ratio (NLR) is a surrogate of perioperative inflammation. Given the potential advantage of an early intervention whenever patients have an elevated NLR, this study aims to evaluate the impact of postoperative NLR on 30-day and 90-day readmissions, and survival in that cohort.
Methods: Patients who underwent liver tumor resection for metastatic CRC at the UPMC Liver Cancer Center between the year 2011-2015 were evaluated. The absolute neutrophil and lymphocyte counts for patients for several post-operative days (POD) were extracted from their charts and used to calculate the NLR. It was analyzed for an association with 30-day and 90-day readmissions by using the multivariate logistic analysis and for overall survival using the Cox proportional-hazards regression analysis.
Results: 262 patients were included in our study. 126 (48.09%) patients were readmitted within 30-days and 245 (93.50%) patients within 90-days. POD 5 NLR was correlated with 30-day readmission (OR:1.07; 95%CI 1.00-1.14; p=0.047). POD 3 NLR was correlated with 90-day readmission (OR: 1.06; 95% CI 1.00-1.12; p=0.04). POD 0 NLR was correlated with survival (HR: 1.102; 95%CI 1.00-1.034; p=0.012).
Conclusion: Post-operative NLR is correlated with an increased 30-day and 90-day readmission and a poorer long-term survival after surgery for metastatic CRC. Having a high NLR postoperatively could be predictive of post-operative outcomes and instigate preventative interventions.