RESUMEN
OBJECTIVE: Surgical site infection (SSI) is a common complication in patients following posterior lumbar spinal surgery. Various laboratory data such as laboratory parameters derived neutrophil/lymphocyte count ratio (NLR), have been applied for the prediction of SSI, but more studies are necessary to evaluate the significance of these indicators. Here, our study aims to investigate the predictive value of total white blood cells (WBCs), count and percentages of neutrophils and leukocytes, NLR, and C-reactive protein (CRP) for surgical site infection (SSI) in patients after posterior lumbar spinal surgery. METHODS: A total of 293 patients who underwent posterior lumbar spinal surgery were enrolled in this study. Each patient's medical history was retrospectively reviewed, and patients were divided into the deep SSI group (nâ¯=â¯13) and the non-SSI group (nâ¯=â¯280). Laboratory data including total WBC, count and percentages of neutrophils and leukocytes, NLR at 1â¯week before the operation and the 4 and 7â¯days post-operation, and CRP at 4 and 7â¯days post-operation were analysed between the SSI and non-SSI groups. Moreover, predictive power and cut-off of NLR for SSI were determined by receiver operating characteristic curve (ROC) results. RESULTS: Data revealed that the medians of NLR were markedly increased in the SSI group as compared to that in non-SSI group at 4â¯days (pâ¯=â¯0.011) and 7â¯days (pâ¯=â¯0.047) post-operation. Moreover, the neutrophil percentage was also dramatically increased in the SSI group at both 4 and 7â¯days post-operation (pâ¯=â¯0.010 and pâ¯=â¯0.030) respectively compared to the non-SSI group. However, no significant difference was observed between the groups 1â¯week before the operation. ROC results showed that NLR at 4â¯days (cut-off >5.19; sensitivity: 61.5%; specificity: 77.6%; AUCâ¯=â¯0.708) and 7â¯days (cut-off >3.85; sensitivity: 69.2%; specificity: 62.7%; AUCâ¯=â¯0.663) post-operation could significantly discriminate the SSI and non-SSI groups. Logistic regression analysis showed that NLR at both post-operative time points (ORâ¯=â¯1.218; pâ¯=â¯0.003 and ORâ¯=â¯1.296; pâ¯=â¯0.048) could be valuable predictors for SSI. CONCLUSION: NLR at 4 and 7â¯days post-operation are valuable laboratory predictors for SSI in patients with posterior lumbar spinal surgery.