Prognostic Value of Preoperative Neutrophil-to-Lymphocyte Ratio and SII

Overview

This systematic review and meta-analysis evaluated the prognostic value of preoperative neutrophil-to-lymphocyte ratio (NLR) and systemic immune-inflammation index (SII) for predicting postoperative pneumonia and pulmonary complications following thoracic surgery. Results indicated that higher preoperative NLR and SII are associated with increased risk of these complications, although the evidence remains limited and retrospective.

Background

Postoperative pneumonia and pulmonary complications are significant risks following thoracic surgery, leading to increased morbidity and mortality. The preoperative immune-inflammatory state, as indicated by biomarkers like NLR and SII, may provide additional insights into patient risk profiles. Understanding these associations could enhance preoperative risk assessment and inform clinical decision-making.

Data Highlights

No numerical data table available.

Key Findings

• Higher preoperative NLR is associated with approximately twofold increased odds of postoperative pneumonia per one-unit increment.
• Categorical analyses suggest a fourfold increase in pneumonia risk above study-specific NLR thresholds.
• Higher preoperative SII indicates more than twice the odds of postoperative complications above specific cut-offs.
• Overall certainty of evidence for these associations is low to very low due to the small number of studies.
• Eight retrospective cohort studies with a total of 3,936 patients were included in the analysis.

Clinical Implications

Preoperative assessment of NLR and SII may serve as low-cost prognostic markers for identifying patients at higher risk for postoperative pneumonia and pulmonary complications. However, further validation in larger, prospective studies is necessary before routine clinical application.

Conclusion

While higher preoperative NLR and SII may indicate increased risk for postoperative complications, the current evidence is limited and requires further investigation.

Related Resources & Content

1. Frontiers | Preoperative Neutrophil-to-Lymphocyte Ratio and Systemic Immune-Inflammation Index as Prognostic Biomarkers for Postoperative Pneumonia and Pulmonary Complications After Thoracic Surgery: A Systematic Review and Meta-Analysis
2. Preoperative Neutrophil-to-Lymphocyte Ratio as an Independent Prognostic Indicator in Gastric Cancer Patients with Postoperative Complications Following Curative Resection
3. Infection — Significance of the Neutrophil-to-Lymphocyte Ratio as a Diagnostic Indicator for Microbiological Samples in Critically Ill Patients Following Liver or Lung Transplantation
4. Link Between Preoperative Neutrophil-to-Lymphocyte Ratio and Postoperative Acute Kidney Injury and Mortality in Major Noncardiac Surgical Procedures
5. Frontiers in Oncology — Association between the prognostic nutritional index and prognosis in patients with non-small cell lung cancer undergoing curative lung resection: a systematic review and meta-analysis
6. Current guidance and risk tools for lung cancer surgery
7. The Society of Thoracic Surgeons Launches Two New Thoracic Surgery Risk Calculators
8. Prediction models for postoperative pulmonary complications: a systematic review and meta-analysis
9. Effect of dynamic lung compliance-guided positive end-expiratory pressure on postoperative pulmonary complications following thoracoscopic lobectomy: a randomized controlled trial | BMC Anesthesiology | Springer Nature Link
10. Postoperative pulmonary complications and their prevention - ScienceDirect
11. Frontiers | Preoperative Neutrophil-to-Lymphocyte Ratio and Systemic Immune-Inflammation Index as Prognostic Biomarkers for Postoperative Pneumonia and Pulmonary Complications After Thoracic Surgery: A Systematic Review and Meta-Analysis
12. Frontiers | Impact of preoperative inflammatory biomarkers on postoperative pneumonia and one-month pulmonary imaging changes after surgery for non-small cell lung cancer