Key result
Elevated preoperative NLR is linked to higher systemic illness and surgical risk scores.
Why the study?
Does preoperative Neutrophil-Lymphocyte Ratio (NLR) correlate with coexisting diseases and established perioperative risk indices in major noncardiac surgical patients?
Cross-Sectional
Does preoperative Neutrophil-Lymphocyte Ratio (NLR) correlate with coexisting diseases and established perioperative risk indices in major noncardiac surgical patients?
Preoperative neutrophil-lymphocyte ratio significantly correlates with established perioperative risk indices, suggesting its potential utility as a simple biomarker for risk stratification in noncardiac surgery.
Should not yet change preoperative risk stratification; leaves open NLR's role pending prospective validation.
BACKGROUND AND AIMS: Neutrophil-lymphocyte ratio (NLR) can predict prognosis of disease in patients suffering from cerebrovascular accidents, ischemic heart disease, infectious diseases, sepsis, etc., that can cause increased postoperative morbidity and prolonged stay in hospital. So, NLR can be a potential preoperative risk assessment and stratification biomarker. Our study aims to estimate any correlation between preoperative NLR and coexisting medical and surgical disease and to validate NLR against American Society of Anesthesiologists Physical Status (ASA PS) Classification System, Revised Cardiac Risk Index (RCRI), Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) score, and Gupta's postoperative respiratory failure risk in Indian patients. MATERIALS AND METHODS: This observational, cross-sectional study was conducted in the preanesthesia check-up clinic. Information regarding sociodemographic profile, primary surgical disease, hematological investigations, that is, complete blood count, neutrophil count, lymphocyte count, NLR, and coexistent medical disease was collected, and ASA PS, RCRI, ARISCAT score, and Gupta's postoperative respiratory failure risk were calculated for each study subject. Data were analyzed using standard statistical tests. RESULTS: Age, congestive cardiac failure, smoking, malignancy, and beta blockers usage were associated with elevated NLR. NLR was found to have a significant relationship with anesthesia risk indices: ASA PS, RCRI, ARISCAT, and Gupta's postoperative respiratory failure risk. CONCLUSION: Significant association has been observed between increased NLR and occurrence of systemic illness. NLR also has a significant association with ASA PS Classification System, RCRI, ARISCAT score, and Gupta's postoperative respiratory failure risk. So, NLR may serve as a valuable biomarker in preoperative risk stratification.
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Nangalia et al. (2026) conducted a cross-sectional in Major noncardiac surgery. Elevated Neutrophil-lymphocyte ratio (NLR) was evaluated on Correlation between preoperative NLR and coexisting medical/surgical disease, and anesthesia risk indices. Elevated preoperative neutrophil-lymphocyte ratio was significantly associated with systemic illness and established anesthesia risk indices, including ASA PS, RCRI, and ARISCAT scores.
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