Value of Preoperative Platelet-to-Lymphocyte and Neutrophil-to-Lymphocyte Ratios in Predicting Postoperative Atrial Fibrillation in Patients Undergoing Lung Resection

Fatih Sivri; Hasan Güngör; Salih Çokpınar; Birgül  Antepüzümü Sezgin; Cemil Zencir

doi:10.18502/jthc.v17i4.11613

Fatih Sivri Department of Cardiology, Hatay Dortyol Hospital, Hatay, Turkey.
Hasan Güngör Department of Cardiology, Adnan Menderes University, Aydin, Turkey.
Salih Çokpınar Department of Thoracic Surgery, Adnan Menderes Unıversty, Aydin, Turkey.
Birgül Antepüzümü Sezgin Department of Thoracic Surgery, Adnan Menderes Unıversty, Aydin, Turkey.
Cemil Zencir Department of Cardiology, Hatay Dortyol Hospital, Hatay, Turkey.

DOI: https://doi.org/10.18502/jthc.v17i4.11613

Keywords: Atrial fibrillation; Lymphocytes, blood; Neutrophils, blood; Blood platelet count

Abstract

Background: The aim of this study was to investigate the association between the platelet/lymphocyte ratio (PLR) and the neutrophil/lymphocyte ratio (NLR) and postoperative atrial fibrillation (POAF) after lung resection.

Methods: After the implementation of the exclusion criteria, 170 patients were retrospectively analyzed. PLR and NLR were obtained from fasting complete blood counts before surgery. POAF was diagnosed using standard clinical criteria. The associations between different variables and POAF, NLR, and PLR were calculated using univariate and multivariate analyses. The receiver operating characteristics (ROC) curve was used to determine the sensitivity and specificity of PLR and NLR.

Results: Of the 170 patients, 32 with POAF (mean age =71.28±7.27 y, 28 males and 4 females) and 138 patients without POAF (mean age =64.69±10.31 y, 125 males and 13 females) were identified, and the difference in the mean age was statistically significant (P=0.001). It was found that PLR (157.67±65.04 vs 127.52±56.80; P=0.005) and NLR (3.90±1.79 vs 2.04±0.88; P=0.001) were statistically significantly higher in the POAF group. In the multivariate regression analysis, age, lung resection size, chronic obstructive pulmonary disease, NLR, PLR, and pulmonary arterial pressure were independent risk factors. In the ROC analysis, PLR had a sensitivity of 100% and a specificity of 33% (AUC, 0.66; P<0.001), and NLR had a sensitivity of 71.9% and a specificity of 87.7% (AUC, 0.87; P<0.001). A comparison of AUC between PLR and NLR showed that NLR was statistically more significant (P<0.001).

Conclusion: This study showed that NLR was a stronger independent risk factor than PLR for the development of POAF after lung resection.