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12.02.2018 | original article | Ausgabe 11-12/2018 Open Access

Wiener klinische Wochenschrift 11-12/2018

Prognostic value of preoperative neutrophil-to-lymphocyte ratio in Crohn’s disease

Zeitschrift:
Wiener klinische Wochenschrift > Ausgabe 11-12/2018
Autoren:
Stanislaus Argeny, Anton Stift, Michael Bergmann, Martina Mittlböck, Svenja Maschke, Yushan Yang, Praminthra Chitsabesan, MD, FRCS Assoc.-Prof. Stefan Riss
Wichtige Hinweise
Author contributions. S. Argeny: conception, data acquisition and interpretation, drafting, final approval. Had full access to all the data in the study and takes responsibility for the integrity of the data and accuracy of the data analysis. Accountable for all aspects of the work. A. Stift: conception, revision, final approval, accountable for all aspects of the work. M. Bergmann: conception, revision, final approval, accountable for all aspects of the work. M. Mittlböck: interpretation, revising and final approval. Responsible for the data analysis, accountable for all aspects of the work. S. Maschke: data acquisition, interpretation, revising, final approval, accountable for all aspects of the work. Y. Yang: data acquisition, revising, final approval, accountable for all aspects of the work. P. Chitsabesan: interpretation, revising, final approval, accountable for all aspects of the work. S. Riss: conception, data acquisition and interpretation, drafting, revising and final approval, accountable for all aspects of the work.
Availability of data and material. The datasets generated and/or analyzed in the current study are not publicly available due to patient privacy but are available from the corresponding author on reasonable request.

Summary

Background

The Neutrophil-to-lymphocyte-ratio has recently gained increased attention as a prognostic marker for malignant disease and short term outcomes. There is little data available in patients with Crohn’s disease, thus the present study was conducted to correlate preoperative Neutrophil-to-lymphocyte-ratio values with disease phenotype and postoperative course.

Methods

We comprised 373 patients, who underwent intestinal resection for symptomatic Crohn’s disease at an academic tertiary referral centre between 2000 and 2014. Preoperative Neutrophil-to-lymphocyte-ratio values were calculated and analyzed in regard to disease phenotype and 30-day morbidity rate. All relevant data were obtained from the institutional database and individual chart review.

Results

Male patients had significantly higher preoperative Neutrophil-to-lymphocyte-ratio values compared to female patients (5 vs. 4; p = 0.0075). A higher Neutrophil-to-lymphocyte-ratio was also found in patients with an acute indication for surgery (6.15 vs. 4.3; p = 0.0374), presenting with abscesses (5.36 vs. 4.28; p = 0.0254), inflammatory masses (5.23 vs. 4.08; p = 0.0294) or malignancy in the resected specimen (9.06 vs. 4.35, p = 0.0231). Surprisingly, patients developing postsurgical complications showed significantly lower Neutrophil-to-lymphocyte-ratio values (3.77 vs. 4.67; p = 0.0461).

Conclusions

Elevated preoperative Neutrophil-to-lymphocyte-ratio in symptomatic Crohn’s disease is not predictive for complications. However, Neutrophil-to-lymphocyte-ratio showed a significant correlation with specific disease phenotypes. Most strikingly, Neutrophil-to-lymphocyte-ratio was highly elevated in patients with a colorectal cancer in the resected specimen, which needs to be addressed in future studies.
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