Associations of novel inflammatory markers with long-term outcomes and recurrence of diverticulitis.
diverticulitis
inflammatory marker
neutrophil-to-lymphocyte ratio
platelet-to-lymphocyte ratio
recurrence
Journal
ANZ journal of surgery
ISSN: 1445-2197
Titre abrégé: ANZ J Surg
Pays: Australia
ID NLM: 101086634
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
received:
02
03
2020
revised:
08
07
2020
accepted:
16
07
2020
pubmed:
29
8
2020
medline:
15
5
2021
entrez:
29
8
2020
Statut:
ppublish
Résumé
The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have emerged as markers of various outcomes of inflammatory and malignant diseases. The association of those markers with short-term outcomes of acute diverticulitis has been discussed in recent studies. This study aimed at evaluation of the association of NLR and PLR with long-term outcomes in patients presenting with acute diverticulitis. A retrospective single institute study included patients admitted with acute diverticulitis between 2012 and 2016. Associations were analysed of NLR and PLR values at admission with patient outcomes. A total of 456 patients were included in the study. High NLR and PLR values were associated with complicated disease (P < 0.01 for both). Among patients with complicated diverticulitis, for those with high NLR, the interval to a recurrent episode of acute diverticulitis was shorter (68.3 days versus 83.7 days, P = 0.044). Patients with high NLR had higher mean number of readmissions (0.54 versus 0.34, P = 0.035). High NLR (10.06 ± 11.23 versus 7.6 ± 8.04, P = 0.012) and PLR (9.64 days ±10.56 versus 7.47 days ±8.225, P = 0.018) were associated with longer cumulative hospital stay due to acute diverticulitis. High NLR and PLR values were associated with recurrence in acute diverticulitis in terms of shorter interval between recurrent episodes and longer cumulative hospitalization days.
Sections du résumé
BACKGROUND
The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have emerged as markers of various outcomes of inflammatory and malignant diseases. The association of those markers with short-term outcomes of acute diverticulitis has been discussed in recent studies. This study aimed at evaluation of the association of NLR and PLR with long-term outcomes in patients presenting with acute diverticulitis.
METHODS
A retrospective single institute study included patients admitted with acute diverticulitis between 2012 and 2016. Associations were analysed of NLR and PLR values at admission with patient outcomes.
RESULTS
A total of 456 patients were included in the study. High NLR and PLR values were associated with complicated disease (P < 0.01 for both). Among patients with complicated diverticulitis, for those with high NLR, the interval to a recurrent episode of acute diverticulitis was shorter (68.3 days versus 83.7 days, P = 0.044). Patients with high NLR had higher mean number of readmissions (0.54 versus 0.34, P = 0.035). High NLR (10.06 ± 11.23 versus 7.6 ± 8.04, P = 0.012) and PLR (9.64 days ±10.56 versus 7.47 days ±8.225, P = 0.018) were associated with longer cumulative hospital stay due to acute diverticulitis.
CONCLUSIONS
High NLR and PLR values were associated with recurrence in acute diverticulitis in terms of shorter interval between recurrent episodes and longer cumulative hospitalization days.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2041-2045Informations de copyright
© 2020 Royal Australasian College of Surgeons.
Références
Jamal Talabani A, Lydersen S, Endreseth BH, Edna T-H. Major increase in admission- and incidence rates of acute colonic diverticulitis. Int. J. Colorectal Dis. 2014; 29: 937-45.
Lee TH, Setty PT, Parthasarathy G et al. Aging, obesity, and the incidence of diverticulitis: a population-based study. Mayo Clin. Proc. 2018; 93: 1256-65.
Horesh N, Wasserberg N, Zbar AP et al. Changing paradigms in the management of diverticulitis. Int. J. Surg. 2016; 33: 146-50.
He W, Yin C, Guo G et al. Initial neutrophil lymphocyte ratio is superior to platelet lymphocyte ratio as an adverse prognostic and predictive factor in metastatic colorectal cancer. Med. Oncol. 2013; 30: 439.
Cannon NA, Meyer J, Iyengar P et al. Neutrophil-lymphocyte and platelet-lymphocyte ratios as prognostic factors after stereotactic radiation therapy for early-stage non-small-cell lung cancer. J. Thorac. Oncol. 2015; 10: 280-5.
Koh C-H, Bhoo-Pathy N, Ng KL et al. Utility of pre-treatment neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as prognostic factors in breast cancer. Br. J. Cancer 2015; 113: 150-8.
Kaplan M, Ates I, Oztas E et al. A new marker to determine prognosis of acute pancreatitis: PLR and NLR combination. J. Med. Biochem. 2018; 37: 21-30.
Lee SK, Lee SC, Park JW, Kim S-J. The utility of the preoperative neutrophil-to-lymphocyte ratio in predicting severe cholecystitis: a retrospective cohort study. BMC Surg. 2014; 14(100).
Kelly ME, Khan A, Riaz M et al. The utility of neutrophil-to-lymphocyte ratio as a severity predictor of acute appendicitis, length of hospital stay and postoperative complication rates. Dig. Surg. 2015; 32: 459-63.
Sato N, Kinoshita A, Imai N et al. Inflammation-based prognostic scores predict disease severity in patients with acute cholecystitis. Eur. J. Gastroenterol. Hepatol. 2018; 30: 484-9.
Yıldırım AC, Anuk T, Günal E, İrem B, Gülkan S. Clinical value of the platelet-to-lymphocyte ratio for diagnosing complicated acute appendicitis. Turk. J. Colorectal Dis. 2017; 27: 1-5.
Ishizuka M, Shimizu T, Kubota K. Neutrophil-to-lymphocyte ratio has a close association with gangrenous appendicitis in patients undergoing appendectomy. Int. Surg. 2012; 97: 299-304.
Hogan J, Sehgal R, Murphy D, O'Leary P, Coffey JC. Do inflammatory indices play a role in distinguishing between uncomplicated and complicated diverticulitis? Dig. Surg. 2017; 34: 7-11.
Mari A, Khoury T, Lubany A et al. Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios are correlated with complicated diverticulitis and Hinchey classification: a simple tool to assess disease severity in the emergency department. Emerg. Med. Int. 2019; 2019: 1-6.
Reynolds IS, Heaney RM, Khan W, Khan IZ, Waldron R, Barry K. The utility of neutrophil to lymphocyte ratio as a predictor of intervention in acute diverticulitis. Dig. Surg. 2017; 34: 227-32.
Sher ME, Agachan F, Bortul M, Nogueras JJ, Weiss EG, Wexner SD. Laparoscopic surgery for diverticulitis. Surg. Endosc. 1997; 11: 264-7.
Diamant MJ, Schaffer S, Coward S et al. Smoking is associated with an increased risk for surgery in diverticulitis: a case control study. PLoS One 2016; 11: e0153871.