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©The Author(s) 2021.
World J Clin Cases. Dec 16, 2021; 9(35): 10816-10827
Published online Dec 16, 2021. doi: 10.12998/wjcc.v9.i35.10816
Published online Dec 16, 2021. doi: 10.12998/wjcc.v9.i35.10816
Table 1 Characteristics of the patients at baseline
Total | WOPC group | PC group | P | |
No. of cases | 206 | 166 | 40 | |
Age (yr) | 62.0 ± 7.2 | 61.6 ± 7.3 | 63.5 ± 6.8 | 0.151 |
Sex | 0.616 | |||
Male | 175 (84.95%) | 140 (84.34%) | 35 (87.50%) | |
Female | 31 (15.05%) | 26 (15.66%) | 5 (12.50%) | |
BMI (kg/m2) | 25.33 ± 2.89 | 25.25 ± 2.85 | 25.63 ± 3.04 | 0.461 |
Smoking history | 118 (57.56%) | 97 (58.79%) | 21 (52.50%) | 0.470 |
ASA grade | 0.521 | |||
Grade II | 157 (81.07%) | 136 (81.93%) | 31 (77.50%) | |
Grade III | 39 (18.93%) | 30 (18.07%) | 9 (22.50%) | |
Preoperative combined diseases | ||||
Hypertension | 146 (70.87%) | 114 (68.67%) | 32 (80.0%) | 0.157 |
Diabetes mellitus | 74 (35.92%) | 61 (36.75%) | 13 (32.50%) | 0.615 |
Heart disease | 56 (27.18%) | 40 (24.10%) | 16 (40.0%) | 0.042a |
Respiratory disease | 11 (5.34%) | 10 (6.02%) | 1 (2.50%) | 0.374 |
Neurological disease | 96 (46.60%) | 78 (46.99%) | 18 (45.0%) | 0.821 |
Kidney disease | 4 (1.94%) | 4 (2.41%) | 0 | 0.321 |
Degree of carotid artery stenosis on the surgical side | 0.449 | |||
Mild/moderate stenosis | 3 (1.46%) | 2 (1.20%) | 1 (2.5%) | |
Severe stenosis | 201 (97.57%) | 163 (98.19%) | 38 (95.0%) | |
Occlusion | 2 (0.97%) | 1 (0.60%) | 1 (2.50%) | |
Degree of carotid artery stenosis on the contralateral side | 0.146 | |||
Mild/moderate stenosis | 169 (85.35%) | 132 (83.02%) | 37 (94.87%) | |
Severe stenosis | 21 (10.61%) | 19 (11.95%) | 2 (5.13%) | |
Occlusion | 8 (4.04%) | 8 (5.03%) | 0 | |
Operating time (min) | 141.33 ± 40.96 | 138.39 ± 38.78 | 153.57 ± 47.62 | 0.129 |
Duration of carotid artery occlusion (min) | 22.00 (18.0–44.0) | 22.00 (17.0–43.0) | 27.0 (18.50–49.50) | 0.328 |
Anesthesia method | ||||
TIVA | 163 (79.13%) | 129 (77.71%) | 34 (85.0%) | 0.309 |
Combined intravenous–inhalation anesthesia | 43 (20.87%) | 37 (22.29%) | 6 (15.0%) | |
Intraoperative intake and output volume (mL) | 897.57 ± 333.40 | 911.85 ± 331.01 | 839.75 ± 341.01 | 0.221 |
meanSBP | 128.82 ± 12.92 | 128.37 ± 12.77 | 130.69 ± 13.54 | 0.309 |
SDSBP | 20.26 ± 4.91 | 20.09 ± 5.01 | 20.93 ± 4.48 | 0.333 |
CVSBP | 0.16 ± 0.04 | 0.16 ± 0.04 | 0.16 ± 0.03 | 0.550 |
meanDBP | 69.61 ± 7.83 | 69.80 ± 7.77 | 68.82 ± 8.14 | 0.480 |
SDDBP | 10.23 ± 2.70 | 10.18 ± 2.81 | 10.42 ± 2.26 | 0.612 |
CVDBP | 0.15 ± 0.04 | 0.15 ± 0.04 | 0.15 ± 0.04 | 0.372 |
Intraoperative use of vasopressors | 84 (40.78%) | 65 (39.16%) | 19 (47.50%) | 0.335 |
Intraoperative use of antihypertensive agents | 73 (35.44%) | 63 (37.95%) | 10 (25.0%) | 0.124 |
Table 2 Outcome variables, stratified by major postoperative complications
Total | WOPC group | PC group | P | |
No. of cases | 206 | 166 | 40 | |
Major postoperative complications | 40 (19.42%) | 0 | 40 (100%) | |
Neurological complications | 16 (7.77%) | 0 | 16 (40.0%) | < 0.001a |
Cardiac complications | 6 (2.91%) | 0 | 6 (15.0%) | < 0.001a |
Respiratory complications | 14 (6.80%) | 0 | 14 (35.0%) | < 0.001a |
AKI | 9 (4.37%) | 0 | 9 (22.50%) | < 0.001a |
Fever | 10 (4.85%) | 4 (2.41%) | 6 (15.0%) | < 0.001a |
Surgical site infections | 3 (1.46%) | 1 (0.60%) | 2 (5.0%) | 0.097 |
Urinary infections | 3 (1.46%) | 1 (0.60%) | 2 (5.0%) | 0.097 |
DVT | 5 (2.43%) | 1 (0.60%) | 4 (10.0%) | < 0.001a |
Length of stay in the ICU (d) | 1.0 (0–1.0) | 1.0 (0–1.0) | 1.0 (1.0–1.0) | 0.055 |
Hospitalization stay (d) | 15.56 ± 4.30 | 15.16 ± 3.63 | 17.20 ± 6.17 | 0.105 |
Cost of hospitalization (CNY) | 24085.15 (21694.72–28395.65) | 23786.67 (21568.68–27139.36) | 27127.94 (22326.75–31629.55) | < 0.001a |
Table 3 Risk factors associated with major postoperative complications
Statistical value | Post-CEA major complications | P | |
Age (yr) | 62.0 ± 7.2 | 1.04 (0.99, 1.09) | 0.151 |
Sex | 0.616 | ||
Male | 175 (84.95%) | 1.0 | |
Female | 31 (15.05%) | 0.77 (0.28, 2.15) | |
BMI (kg/m2) | 25.33 ± 2.89 | 1.05 (0.93, 1.17) | 0.459 |
ASA grade | 0.522 | ||
Grade II | 167 (81.07%) | 1.0 | |
Grade III | 39 (18.93%) | 1.32 (0.57, 3.05) | |
Anesthesia methods | 0.312 | ||
TIVA | 163 (79.13%) | 1.0 | |
Combined intravenous–inhalation anesthesia | 43 (20.87%) | 0.62 (0.24, 1.58) | |
Degree of carotid artery stenosis on the surgical side | |||
Mild/moderate stenosis | 3 (1.46%) | 1.0 | |
Severe stenosis | 201 (97.57%) | 0.47 (0.04, 5.28) | 0.538 |
Occlusion | 2 (0.97%) | 2.00 (0.05, 78.25) | 0.711 |
Degree of carotid artery stenosis on the contralateral side | |||
Mild/moderate stenosis | 169 (85.35%) | 1.0 | |
Severe stenosis | 21 (10.61%) | 0.38 (0.08, 1.69) | 0.201 |
Occlusion | 8 (4.04%) | 0 (0, Inf) | 0.986 |
Operating time (min) | 141.33 ± 40.96 | 1.01 (1.0, 1.02) | 0.038a |
Intraoperative intake and output volume (mL) | 897.57 ± 333.40 | 1.00 (1.0, 1.00) | 0.221 |
Duration of carotid artery occlusion | 22.0 (18.0–44.0) | 1.01 (0.99, 1.03) | 0.327 |
CVSBP | 0.16 ± 0.04 | 16.36 (0.00, 150500.70) | 0.548 |
CVDBP | 0.15 ± 0.04 | 40.21 (0.01, 132798.95) | 0.372 |
Preoperative NLR | 2.08 ± 0.94 | 1.21 (0.87, 1.69) | 0.264 |
NLR within 24 h after CEA | 5.68 (3.93–8.91) | 1.09 (1.01, 1.17) | 0.026a |
Table 4 Correlation between neutrophil to lymphocyte ratio within 24 h after carotid endarterectomy and major postoperative complications
Exposure factors | Unadjusted | P value | Model I | P value | Model II | P |
NLR | 1.09 (1.01, 1.17) | 0.026a | 1.08 (1.00, 1.16) | 0.041a | 1.15 (1.03, 1.29) | 0.014a |
NLR tertile groups | ||||||
Low NLR group | 1.0 | 1.0 | 1.0 | |||
Middle NLR group | 1.60 (0.63, 4.09) | 0.322 | 1.52 (0.59, 3.92) | 0.386 | 3.99 (1.03, 15.49) | 0.046a |
High NLR group | 2.92 (1.21, 7.02) | 0.017a | 2.88 (1.17, 7.09) | 0.022a | 8.47 (2.20, 32.63) | 0.002a |
Table 5 Outcome variables, stratified by NLR ratio tertile groups
Total | Low NLR group | Middle NLR group | High NLR group | P | |
No. of cases | 206 | 68 | 69 | 69 | |
Major postoperative complications | 40 (19.42%) | 8 (11.76%) | 11 (15.94%) | 21 (30.43%) | 0.015a |
Neurological complications | 16 (7.77%) | 4 (5.88%) | 4 (5.80%) | 8 (11.59%) | 0.346 |
Cardiac complications | 6 (2.91%) | 0 (0.00%) | 3 (4.35%) | 3 (4.35%) | 0.218 |
Respiratory complications | 14 (6.80%) | 2 (2.94%) | 5 (7.25%) | 7 (10.14%) | 0.242 |
AKI | 9 (4.37%) | 2 (2.94%) | 1 (1.45%) | 6 (8.70%) | 0.089 |
Fever | 10 (4.85%) | 1 (1.47%) | 2 (2.90%) | 7 (10.14%) | 0.040a |
Surgical site infections | 3 (1.46%) | 1 (1.47%) | 1 (1.45%) | 1 (1.45%) | 1.000 |
Urinary infections | 3 (1.46%) | 0 (0.00%) | 1 (1.45%) | 2 (2.90%) | 0.367 |
DVT | 5 (2.43%) | 2 (2.94%) | 1 (1.45%) | 1 (1.45%) | 0.766 |
Length of stay in the ICU (d) | 1.0 (0–1.0) | 1.0 (0–1.0) | 1.0 (0–1.0) | 1.0 (1.0–1.0) | 0.079 |
Hospitalization stay (d) | 15.56 ± 4.30 | 15.44 ± 4.40 | 15.28 ± 4.27 | 15.96 ± 4.26 | 0.627 |
Cost of hospitalization (CNY) | 26886.26 ± 11277.49 | 24371.70 ± 5233.73 | 26837.07 ± 12681.34 | 29413.56 ± 13520.49 | 0.032a |
- Citation: Yu Y, Cui WH, Cheng C, Lu Y, Zhang Q, Han RQ. Association between neutrophil-to-lymphocyte ratio and major postoperative complications after carotid endarterectomy: A retrospective cohort study. World J Clin Cases 2021; 9(35): 10816-10827
- URL: https://www.wjgnet.com/2307-8960/full/v9/i35/10816.htm
- DOI: https://dx.doi.org/10.12998/wjcc.v9.i35.10816