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Ann R Coll Surg Engl ; 100(4): 308-315, 2018 Apr.
Article de Anglais | MEDLINE | ID: mdl-29364006

RÉSUMÉ

Introduction The association between the neutrophil-lymphocyte ratio (NLR) and outcome in elective colorectal cancer surgery is well established; the relationship between NLR and the emergency colorectal cancer patient is, as yet, unexplored. This paper evaluates the predictive quality of the NLR for outcome in the emergency colorectal cancer patient. Materials and Methods A total of 187 consecutive patients who underwent emergency surgery for colorectal cancer were included in the study. NLR was calculated from the haematological tests done on admission. Receiver operating characteristic analyses were used to determine the most suitable cut-off for NLR. Outcomes were assessed by mortality at 30 and 90 days using stepwise Cox proportional hazards regression. Results An NLR cut-off of 5 was found to have the highest sensitivity and specificity. At 30 days, age and time from admission to surgery were associated with increased mortality; a high NLR was associated with an increased risk of mortality in univariate but not multivariate analysis. At 90 days, age, NLR, time from admission to surgery and nodal status were all significantly associated with increased mortality on multivariate analysis. Conclusions Pre-operative NLR is a cheap, easily performed and useful clinical tool to aid prediction of outcome in the emergency colorectal cancer patient.


Sujet(s)
Tumeurs colorectales/sang , Procédures de chirurgie digestive/statistiques et données numériques , Traitement d'urgence/statistiques et données numériques , Lymphocytes , Granulocytes neutrophiles , Sélection de patients , Facteurs âges , Sujet âgé , Sujet âgé de 80 ans ou plus , Tumeurs colorectales/mortalité , Tumeurs colorectales/anatomopathologie , Tumeurs colorectales/chirurgie , Procédures de chirurgie digestive/effets indésirables , Procédures de chirurgie digestive/méthodes , Traitement d'urgence/méthodes , Femelle , Humains , Numération des leucocytes , Métastase lymphatique , Mâle , Analyse multifactorielle , Période postopératoire , Valeur prédictive des tests , Période préopératoire , Pronostic , Courbe ROC , Études rétrospectives , Analyse de survie , Facteurs temps , Résultat thérapeutique
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