PDF(Pubmed)
Abstract：
UNASSIGNED: Development of sepsis is a major contributor to poor outcomes after liver transplant. The neutrophil-lymphocyte ratio (NLR) is an easily calculable inflammatory biomarker. We aim to utilize NLR to diagnose and predict the onset of sepsis in patients undergoing living donor liver transplants (LDLT).
UNASSIGNED: Analysis of the perioperative course of 314 consecutive adult patients who underwent elective ABO compatible LDLT was done. Patients were divided into two cohorts; those who developed sepsis and a control group. Sepsis was defined by the combination of SIRS and clinical/radiological suspicion of infection. NLR was calculated by dividing the percentage of neutrophils by the percentage of lymphocytes in peripheral blood.
UNASSIGNED: ostoperatively, 127 out of 314 patients (40.5%) having at least one episode of sepsis were included in the septic cohort and were compared to the 187 (59.5%) patients in the control group. Demographic and baseline characteristics, including NLR (13.74 ± 0.99 vs. 12.65 ± 0.57, P = 0.294) were comparable preoperatively. The NLR of the septic cohort was significantly higher than the control cohort (15.01 ± 1.67 vs. 9.98 ± 0.63, P = 0.001) 3 days prior to sepsis and remained significantly higher till the day of sepsis. The area under the cover was maximum for NLR 1 day prior to the development of sepsis (r = 0.707) with a sensitivity, specificity, positive predictive value, and negative predictive value of 62.4%, 62.2%, 51.4%, and 72.0%, respectively, at a cutoff of 8.5.
UNASSIGNED: NLR is a useful tool in diagnosing and pre-empting development of sepsis in LDLT.
UNASSIGNED: Analysis of the perioperative course of 314 consecutive adult patients who underwent elective ABO compatible LDLT was done. Patients were divided into two cohorts; those who developed sepsis and a control group. Sepsis was defined by the combination of SIRS and clinical/radiological suspicion of infection. NLR was calculated by dividing the percentage of neutrophils by the percentage of lymphocytes in peripheral blood.
UNASSIGNED: ostoperatively, 127 out of 314 patients (40.5%) having at least one episode of sepsis were included in the septic cohort and were compared to the 187 (59.5%) patients in the control group. Demographic and baseline characteristics, including NLR (13.74 ± 0.99 vs. 12.65 ± 0.57, P = 0.294) were comparable preoperatively. The NLR of the septic cohort was significantly higher than the control cohort (15.01 ± 1.67 vs. 9.98 ± 0.63, P = 0.001) 3 days prior to sepsis and remained significantly higher till the day of sepsis. The area under the cover was maximum for NLR 1 day prior to the development of sepsis (r = 0.707) with a sensitivity, specificity, positive predictive value, and negative predictive value of 62.4%, 62.2%, 51.4%, and 72.0%, respectively, at a cutoff of 8.5.
UNASSIGNED: NLR is a useful tool in diagnosing and pre-empting development of sepsis in LDLT.
摘要：
脓毒症的发展是肝移植后不良预后的主要原因。中性粒细胞-淋巴细胞比率（NLR）是一种易于计算的炎症生物标志物。我们的目标是利用NLR来诊断和预测接受活体供体肝移植（LDLT）的患者的败血症发作。
■对314例接受选择性ABO相容性LDLT的连续成年患者的围手术期进行分析。患者被分为两组；那些发生败血症的人和对照组。通过SIRS和临床/放射学怀疑感染的组合来定义脓毒症。通过将中性粒细胞的百分比除以外周血中淋巴细胞的百分比来计算NLR。
■有至少一次脓毒症发作的314名患者中有127名（40.5%）被纳入脓毒症队列，并与对照组的187名（59.5%）患者进行比较。人口统计学和基线特征，包括NLR(13.74±0.99vs.12.65±0.57，P=0.294）在术前具有可比性。脓毒症队列的NLR显着高于对照组（15.01±1.67vs.9.98±0.63，P=0.001）在脓毒症发生前3天，并在脓毒症发生当天保持明显升高。在脓毒症发生前1天，NLR覆盖下的面积最大（r=0.707），特异性，正预测值，阴性预测值为62.4%，62.2%,51.4%,72.0%,分别,截止时间为8.5。
■NLR是诊断和预防LDLT中败血症发展的有用工具。
■对314例接受选择性ABO相容性LDLT的连续成年患者的围手术期进行分析。患者被分为两组；那些发生败血症的人和对照组。通过SIRS和临床/放射学怀疑感染的组合来定义脓毒症。通过将中性粒细胞的百分比除以外周血中淋巴细胞的百分比来计算NLR。
■有至少一次脓毒症发作的314名患者中有127名（40.5%）被纳入脓毒症队列，并与对照组的187名（59.5%）患者进行比较。人口统计学和基线特征，包括NLR(13.74±0.99vs.12.65±0.57，P=0.294）在术前具有可比性。脓毒症队列的NLR显着高于对照组（15.01±1.67vs.9.98±0.63，P=0.001）在脓毒症发生前3天，并在脓毒症发生当天保持明显升高。在脓毒症发生前1天，NLR覆盖下的面积最大（r=0.707），特异性，正预测值，阴性预测值为62.4%，62.2%,51.4%,72.0%,分别,截止时间为8.5。
■NLR是诊断和预防LDLT中败血症发展的有用工具。
