Key result
Patients with a pre-operative neutrophil-to-lymphocyte ratio ≥2 required significantly more oral morphine equivalents in the first 48 hours after thoracotomy compared to those with a ratio <2 (140.8 vs 109.7 mg).
Why the study?
Surgical pain and prolonged hospital length of stay affect many patients after thoracotomy, and inflammation plays a crucial role in pain and outcomes.
Is pre-operative neutrophil-to-lymphocyte ratio associated with post-operative opioid requirements and length of stay in patients undergoing thoracotomy?
Observational (n=137)
No
Is pre-operative neutrophil-to-lymphocyte ratio associated with post-operative opioid requirements and length of stay in patients undergoing thoracotomy?
Higher pre-operative neutrophil-to-lymphocyte ratio is associated with increased post-operative opioid requirements and longer hospital length of stay after thoracotomy.
Answers are grounded in this paper and cite their sources.
Pre-op NLR was associated with post-thoracotomy pain and LOS; hypothesis-generating and requires prospective validation before clinical use.
BACKGROUND: Surgical pain and prolonged hospital length of stay (LOS) affect a large proportion of patients after thoracotomy. Inflammation plays a crucial role in the mechanism and progression of pain and the outcomes. AIM: The objective of this study was to investigate the association between the pre-operative neutrophil-to-lymphocyte ratio (NLR) and post-operative pain and LOS in patients undergoing thoracotomy. METHODS: This was a retrospective, observational study on 157 patients who underwent thoracotomy under general anesthesia. We classified the subjects into two study groups: Group with for patients with NLR <2 and Group 2 for NLR ≥2. We measured the post-operative pain by gathering the data of post-operative opioid needs. We used Pearson’s and Spearman’s correlation tests to assess the association of the parameters. RESULTS: The mean of total oral morphine equivalent in the first 48 h following thoracotomy in Group 1 was 140.8 ± 60.4 mg compared to Group 2’s 109.7 ± 55.8 (p < 0.05). The median hospital’s LOS was longer in Group 2 compared to Group 1 (7 vs. 10, p < 0.001). We found a weak positive correlation between pre-operative NLR (R = 0.267, p = 0.002) and post-operative opioid requirements, and a weak positive correlation between pre-operative NLR and the hospital’s LOS (R = 0.345, p < 0.001). CONCLUSION: Pre-operative NLR correlates with post-operative opioid requirements and the time hospital’s LOS in patients who underwent elective thoracotomy.
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Suranadi et al. (2020) conducted an observational in Thoracotomy (n=137). Pre-operative Neutrophil-to-Lymphocyte Ratio (NLR) ≥2 vs. Pre-operative NLR <2 was evaluated on Total oral morphine equivalent required in the first 48 hours after surgery (mg) (p=0.002). Patients with a pre-operative neutrophil-to-lymphocyte ratio ≥2 required significantly more oral morphine equivalents in the first 48 hours after thoracotomy compared to those with a ratio <2 (140.8 vs 109.7 mg).
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