Abstract：
BACKGROUND: Patients undergoing cardiac surgery are at significant risk of developing postoperative acute kidney injury (AKI). Neutrophil-lymphocyte ratio (NLR) is a widely available inflammatory biomarker which may be of prognostic value in this setting.
METHODS: We conducted a systematic review and meta-analysis of studies reporting associations between perioperative NLR with postoperative AKI. We searched Medline, Embase and the Cochrane Library, without language restriction, from inception to May 2022 for relevant studies. We meta-analysed the reported odds ratios (ORs) with 95% confidence intervals (CIs) for both elevated preoperative and postoperative NLR with risk of postoperative AKI and need for renal replacement therapy (RRT). We conducted a meta-regression to explore inter-study statistical heterogeneity.
RESULTS: Twelve studies involving 10,724 participants undergoing cardiac surgery were included, with eight studies being deemed at high risk of bias using PROBAST modelling. We found statistically significant associations between elevated preoperative NLR and postoperative AKI (OR 1.45, 95% CI 1.18-1.77), as well as postoperative need for RRT (OR 2.37, 95% CI 1.50-3.72). Postoperative NLR measurements were not of prognostic significance.
CONCLUSIONS: Elevated preoperative NLR is a reliable inflammatory biomarker for predicting AKI following cardiac surgery.
METHODS: We conducted a systematic review and meta-analysis of studies reporting associations between perioperative NLR with postoperative AKI. We searched Medline, Embase and the Cochrane Library, without language restriction, from inception to May 2022 for relevant studies. We meta-analysed the reported odds ratios (ORs) with 95% confidence intervals (CIs) for both elevated preoperative and postoperative NLR with risk of postoperative AKI and need for renal replacement therapy (RRT). We conducted a meta-regression to explore inter-study statistical heterogeneity.
RESULTS: Twelve studies involving 10,724 participants undergoing cardiac surgery were included, with eight studies being deemed at high risk of bias using PROBAST modelling. We found statistically significant associations between elevated preoperative NLR and postoperative AKI (OR 1.45, 95% CI 1.18-1.77), as well as postoperative need for RRT (OR 2.37, 95% CI 1.50-3.72). Postoperative NLR measurements were not of prognostic significance.
CONCLUSIONS: Elevated preoperative NLR is a reliable inflammatory biomarker for predicting AKI following cardiac surgery.
摘要：
背景：接受心脏手术的患者有发生术后急性肾损伤（AKI）的显著风险。中性粒细胞-淋巴细胞比率（NLR）是一种广泛可用的炎症生物标志物，在这种情况下可能具有预后价值。
方法：我们对报告围手术期NLR与术后AKI之间关联的研究进行了系统评价和荟萃分析。我们搜查了Medline,Embase和Cochrane图书馆,没有语言限制，从成立到2022年5月进行相关研究。我们荟萃分析了术前和术后NLR升高，术后AKI风险和需要肾脏替代疗法（RRT）的比值比（ORs）和95％置信区间（CIs）。我们进行了荟萃回归来探索研究间的统计异质性。
结果：纳入了12项研究，涉及10,724名接受心脏手术的参与者，8项研究使用PROBAST建模被认为存在高偏倚风险。我们发现术前NLR升高与术后AKI之间有统计学意义的关联（OR1.45，95％CI1.18-1.77），以及术后RRT的需要(OR2.37，95%CI1.50-3.72)。术后NLR测量无预后意义。
结论：术前NLR升高是预测心脏手术后AKI的可靠炎症生物标志物。
方法：我们对报告围手术期NLR与术后AKI之间关联的研究进行了系统评价和荟萃分析。我们搜查了Medline,Embase和Cochrane图书馆,没有语言限制，从成立到2022年5月进行相关研究。我们荟萃分析了术前和术后NLR升高，术后AKI风险和需要肾脏替代疗法（RRT）的比值比（ORs）和95％置信区间（CIs）。我们进行了荟萃回归来探索研究间的统计异质性。
结果：纳入了12项研究，涉及10,724名接受心脏手术的参与者，8项研究使用PROBAST建模被认为存在高偏倚风险。我们发现术前NLR升高与术后AKI之间有统计学意义的关联（OR1.45，95％CI1.18-1.77），以及术后RRT的需要(OR2.37，95%CI1.50-3.72)。术后NLR测量无预后意义。
结论：术前NLR升高是预测心脏手术后AKI的可靠炎症生物标志物。
