Prognostic Significance of Preoperative Neutrophil-to-lymphocyte Ratio and Platelet-to-lymphocyte Ratio in Patients with Ruptured Abdominal Aortic Aneurysm Undergoing Endovascular Aneurysm Repair

J Cardiothorac Surg. 2024 Dec 19;19(1):650. doi: 10.1186/s13019-024-03165-0.

Abstract

Background: Ruptured abdominal aortic aneurysm (RAAA) is a fatal disease. This study aimed to assess the prognostic value of the preoperative neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in patients with RAAA undergoing endovascular aneurysm repair (EVAR).

Materials and methods: This retrospective study included patients with RAAA who underwent EVAR from 2012 to 2022. NLR and PLR were measured when patients were first admitted to the hospital before receiving any treatment. Risk factors associated with overall survival in this patient group were identified through univariate and multivariate analyses. Nomograms and artificial neural networks were developed to evaluate the prognosis of these patients.

Results: A total of 50 patients were included in this study. The optimal cut-off points for predicting overall survival were an NLR of 19.6 and a PLR of 190.5. Univariate and multivariate analyses revealed that NLR (hazard ratio 0.271, p = 0.024) and PLR (hazard ratio 0.272, p = 0.041). Were independent risk factors for overall survival. Nomograms and artificial neural networks also showed the prognostic value of preoperative NLR and PLR in this patient group.

Conclusion: Preoperative NLR and PLR are independent and valid predictors of prognosis in patients with RAAA undergoing EVAR. The higher the preoperative NLR and PLR of the patients, the worse their prognosis.

Keywords: Endovascular aneurysm repair; Neutrophil-to-lymphocyte ratio; Platelet-to-lymphocyte ratio; Prognosis; Ruptured abdominal aortic aneurysm.

MeSH terms

  • Aged
  • Aortic Aneurysm, Abdominal* / blood
  • Aortic Aneurysm, Abdominal* / mortality
  • Aortic Aneurysm, Abdominal* / surgery
  • Aortic Rupture* / blood
  • Aortic Rupture* / mortality
  • Aortic Rupture* / surgery
  • Blood Platelets
  • Endovascular Aneurysm Repair
  • Endovascular Procedures*
  • Female
  • Humans
  • Lymphocyte Count
  • Lymphocytes
  • Male
  • Middle Aged
  • Neutrophils*
  • Nomograms
  • Platelet Count
  • Preoperative Period
  • Prognosis
  • Retrospective Studies
  • Risk Factors