Neutrophil/lymphocyte ratio as a predictor of severe postoperative edema and ecchymosis in open rhinoplasty surgery

Tugcugil, Ersagun; undefined, Murat; Akdogan, Ali; Besir, Ahmet

doi:10.17826/cumj.1134070

Neutrophil/lymphocyte ratio as a predictor of severe postoperative edema and ecchymosis in open rhinoplasty surgery

Ahmet BEŞİR, (Karadeniz Teknik Üniversitesi, Tıp Fakültesi, Anesteziyoloji ve Yoğun Bakım Anabilim Dalı, Trabzon, Türkiye)

Ersagun TUGCUGIL, (Karadeniz Teknik Üniversitesi, Tıp Fakültesi, Anesteziyoloji ve Yoğun Bakım Anabilim Dalı, Trabzon, Türkiye)

Ali AKDOGAN, (Karadeniz Teknik Üniversitesi, Tıp Fakültesi, Anesteziyoloji ve Yoğun Bakım Anabilim Dalı, Trabzon, Türkiye)

Murat Livaoğlu (Karadeniz Teknik Üniversitesi, Tıp Fakültesi, Plastik ve Rekonstrüktif Cerrahi, Trabzon, Türkiye)

Cukurova Medical Journal

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Yıl: 2022 Cilt: 47 Sayı: 4 Sayfa Aralığı: 1568 - 1577 Metin Dili: İngilizce DOI: 10.17826/cumj.1134070 İndeks Tarihi: 09-01-2023

Neutrophil/lymphocyte ratio as a predictor of severe postoperative edema and ecchymosis in open rhinoplasty surgery

Öz:

Purpose: This study investigated the relationship between preoperative neutrophil-to-lymphocyte ratio (NLR) and severe postoperative edema and ecchymosis after open rhinoplasty. Materials and Methods: The study was carried out retrospectively in 165 ASA I-II patients aged 18-45 years who underwent open rhinoplasty in the Department of Plastic and Reconstructive Surgery. The patients were grouped based on their scores on the edema and ecchymosis scales. The degree of edema and ecchymosis was considered “minimal” (Group M) in those scoring 0-2 points and “severe” (Group S) in those scoring 3-4 points. Periorbital edema and ecchymosis of the patients in both groups were scored based on the digital photographs taken on the 1st postoperative day. Results: There was no significant difference in the demographic and clinical characteristics of the patients grouped according to the degree of edema and ecchymosis. The optimal cut-off value of NLR was 2.1 (AUC = 0.747, Sensitivity = 0.666, Specificity = 0.707) for edema and 1.5 (AUC = 0.747, Sensitivity = 0.869, Specificity = 0.470) for ecchymosis. Multivariable analyzes for the development of edema and ecchymosis identified NLR (4.67 [2.38-9.40] and 6.54 [3.02-15.08, respectively) as a statistically significant independent prognostic factor. Conclusion: This study identified preoperative NLR as a predictor value of severe postoperative edema and ecchymosis after open rhinoplasty.

Anahtar Kelime: Neutrophil/lymphocyte ratio open rhinoplasty edema ecchymosis predictive value.

Açık rinoplasti cerrahisinde postoperatif şiddetli ödem ve ekimozun bir göstergesi olarak nötrofil/lenfosit oranı

Öz:

Amaç: Çalışmamızda açık rinoplastilerde preoperatif nötrofil/lenfosit oranı (NLR) ile postoperatif şiddetli ödem ve ekimoz arasındaki ilişki araştırılmıştır. Gereç ve Yöntem: Çalışma Plastik ve Rekonstrüktif Cerrahisi tarafından açık rinoplasti uygulanan 18-45 yaş, ASA I-II 165 hastada retrospektif olarak gerçekleştirildi. Hastalar ödem ve ekimoz skalalarına göre, ödem ve ekimoz skoru 0-2 olanlar “minimal” (Group M), 3-4 olanlar “severe” (Group S) olarak gruplara ayrıldı. Grupların postoperatif 1. günde digital ortamda gerçekleştirilen fotoğraflarından periorbital ödem ve ekimoz skorları incelendi. Bulgular: Hastaların ödem ve ekimoz varlığına göre grupların karşılaştırılmasında demografik ve klinik veriler arasında anlamlı bir fark yoktu. NLR nin optimal cut-off değeri ödem için 2.1 (AUC = 0.747, Sensitivite = 0.666, Spesifisite = 0.707), ekimoz için 1.5 (AUC = 0.747, Sensitivite = 0.869, Spesifisite = 0.470) olarak bulundu. Ödem ve ekimoz gelişimi için yapılan multivariable analizlerde NLR (sırasıyla, 4.67 [2.38-9.40] and 6.54 [3.02-15.08]) istatistiksel olarak anlamlı bağımsız prognostik faktör olarak saptandı. Sonuç: Bu çalışmada preoperatif NLR’nin açık rinoplasti operasyonlarından sonra görülen şiddetli ödem ve ekimoz için öngörücü bir değer olduğu sonucuna vardık.

Anahtar Kelime: Nötrofil/lenfosit oranı açık rinoplasti ekimoz tahmin edici değer

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Gürlek A, Fariz A, Aydoğan H, Ersöz-Oztürk A, Evans G R D. Effects of high dose corticosteroids in open rhinoplasty. J Plast Reconstr Aesthet Surg 2009;62: 650-5.
2. Holt GR, Garner ET, McLarey D. Postoperative sequelae and complications of rhinoplasty. Otolaryngol Clin North Am 1987;20(4):853-76.
3. Ryan TJ. Structure and functions of lymphatics. J Invest Dermatol 1989;93:18–24.
4. Kara CO, Gökalan I. Effects of single-dose steroid usage on edema, ecchymosis, and intraoperative bleeding in rhinoplasty. Plast Reconstr Surg 1999;104(7): 2213-8.
5. Sarraf KM, Belcher E, Raevsky E, Nicholson AG, Goldstraw P, Lim E. Neutrophil/lymphocyte ratio and its association with survival after complete resection in non-small cell lung cancer. J Thorac Cardiovasc Surg 2009;137:425e8.
6. Walsh SR, Cook EJ, Goulder F, Justin TA, Keeling NJ. Neutrophil-lymphocyte ratio as a prognostic factor in colorectal cancer. J Surg Oncol 2005;91:181e4.
7. Yamanaka T, Matsumoto S, Teramukai S, Ishiwata R, Nagai Y, Fukushima M. The baseline ratio of neutrophils to lymphocytes is associated with patient prognosis in advanced gastric cancer. Oncology 2007;73:215e20.
8. Takahashi J, Shono Y, Hirabayashi H, Kamimura M, Nakagawa H, Ebara S, et al. Usefulness of white blood cell differential for early diagnosis of surgical wound infection following spinal instrumentation surgery. Spine 2006;31:1020e5.
9. Kim WH, Jin HS, Ko JS, Hahm TS, Lee SM, Cho HS, et al. The effect of anesthetic techniques on neutrophil-to-lymphocyte ratio after laparoscopy-assisted vaginal hysterectomy. Acta Anaesthesiol Taiwan 2011;49(3):83-7.
10. Neal CP, Mann CD, Sutton CD, Garcea G, Ong SL, Steward WP, et al. Evaluation of the prognostic value of systemic inflammation and socioeconomic deprivation in patients with resectable colorectal liver metastases. Eur J Cancer 2009;45:56e64.
11. Tuncel U, Turan A, Bayraktar MA, Erkorkmaz U, Kostakoglu N. Efficacy of dexamethasone with controlled hypotension on intraoperative bleeding, postoperative oedema and ecchymosis in rhinoplasty. J Craniomaxillofac Surg 2013;41:124–8.
12. Hoffmann DF, Cook TA, Quatela VC, Wang TD, Brownrigg PJ, Brummett RE. Steroids and rhinoplasty: a double-blind study. Arch Otolaryngol Head Neck Surg. 1991;117(9):990-3
13. Holt GR, Garner ET, McLarey D. Postoperative sequelae and complications of rhinoplasty. Otolaryngol Clin North Am. 1987;20(4):853-76.
14. Ong AA, Farhood Z, Kyle AR, Patel KG. Interventions to decrease postoperative edema and ecchymosis after rhinoplasty: a systematic review of the literature. Plast Reconstr Surg. 2016;137(5):1448-62.
15. Koc S, Gurbuzler L, Yaman H, Eyibilen A, Süren M, Kaya Z, et al. The effectiveness of steroids foredema, ecchymosis, and intraoperative bleeding in rhinoplasty. Am JRhinol Allergy 2011;25:e95–e98.
16. Pulikkottil BJ, Dauwe P, Daniali L, Rohrich RJ. Corticosteroid use in cosmetic plastic surgery. Plast Reconstr Surg 2013;132: 352e–360e.
17. Kara CO, Kara IG, Yaylali V. Subconjunctival ecchymosis due to rhinoplasty. Rhinology 2001;39: 166–8.
18. Balta S, Celik T, Mikhailidis DP, Ozturk C, Demirkol S, Aparci M, et al. The Relation Between Atherosclerosis and the Neutrophil-Lymphocyte Ratio. Clin Appl Thromb Hemost 2016;22(5):405-11.
19. Bhutta H, Agha R, Wong J, Tang TY, Wilson YG, Walsh SR. Neutrophil–lymphocyte ratio predicts medium-term survival following elective major vascular surgery: a cross-sectional study. Vasc Endovascular Surg 2011;45(3):227-31.
20. Ozturk C, Balta S, Balta I, Demirkol S, Celik T, Turker T, et al. Neutrophil-lymphocyte ratio and carotid-intima media thickness in patients with Behçet disease without cardiovascular involvement. Angiology 2015;66(3):291-6.
21. Ozturk C, Balta S, Balta I, Celik T. Neutrophil-lymphocyte ratio in Behçet disease. Angiology 2015;66(7):695.
22. Kalay N, Dogdu O, Koc F, Yarlioglues M, Ardic I, Akpek M, et al. Hematologic parameters and angiographic progression of coronary atherosclerosis. Angiology 2012;63(3):213-7.
23. Park B-J, Shim J-Y, Lee H-R, Lee J-H, Jung D-H, Kim H-B, et al. Relationship of neutrophil– lymphocyte ratio with arterial stiffness and coronary calcium score. Clin Chim Acta 2011;412:925-9.
24. Tasoglu I, Cicek OF, Lafci G, Kadiroğullari E, Sert DE, Demir A, et al. Usefulness of neutrophil/ lymphocyte ratio as a predictor of amputation after embolectomy for acute limb ischemia. Ann Vasc Surg 2014;28(3): 606-13.
25. Tasoglu I, Turak O, Nazli Y, Ozcan F, Colak N, Sahin S, et al. Preoperative neutrophil– lymphocyte ratio and saphenous vein graft patency after coronary artery bypass grafting. Clin Appl Thromb Hemost 2014;20(8): 819-24.
26. Balta I, Akbay G, Kalkan G, Eksioglu M. Demographic and clinical features of 521 Turkish patients with Behc¸et’s disease. Int J Dermatol 2014;53(5):564-9.
27. Ekiz O, Balta I, Sen BB, Rifaioglu EN, Ergin C, Balta S, et al. Mean platelet volume in recurrent aphthous stomatitis and Behçet disease. Angiology 2014;65(2): 161-5.
28. Balta I, Balta S, Koryurek OM, Demirkol S, Mikhailidis DP, Celik T. Serum endocan levels as a marker of disease activity in patients with Behçet disease. J Am Acad Dermatol 2014;70(2):291-6.
29. Makay B, Gücenmez ÖA, Duman M, Ünsal E. The relationship of neutrophil-tolymphocyte ratio with gastrointestinal bleeding in Henoch-Schonlein purpura. Rheumatol Int 2014;34(9):1323-7.
30. Forget P, Khalifa C, Defour JP, Latinne D, Pel VMC, Kock MD. What is the normal value of the neutrophil-to-lymphocyte ratio? BMC Res Notes 2017;3;10(1):12.
31. Gibson PH, Croal BL, Cuthbertson BH, Small GR, Ifezulike AI, Gibson G. Preoperative neutrophil lymphocyte ratio and outcome from coronary artery bypass grafting. Am Heart J 2007;154(5):995–1002.
32. Hung HY, Chen JS, Yeh CY, Changchien CR, Tang R, Hsieh PS. Effect of preoperative neutrophil lymphocyte ratio on the surgical outcomes of stage II colon cancer patients who do not receive adjuvant chemotherapy. Int J Colorectal Dis 2011;26(8):1059–65.
33. Tomita M, Shimizu T, Ayabe T, Yonei A, Onitsuka T. Preoperative neutrophil to lymphocyte ratio as a prognostic predictor after curative resection for non-small cell lung cancer. Anticancer Res 2011;31(9):2995–8.
34. Kahramanca S, Ozgehan G, Seker D, Gökce EI, Seker G, Tunç G. Neutrophil-to-lymphocyte ratio as a predictor of acute appendicitis. Ulus Travma Acil Cerrahi Derg 2014;20(1):19–22.
35. Templeton AJ, McNamara MG, Seruga B, Vera-Badillo FE, Aneja P, Ocaña A. Prognostic role of neutrophil-tolymphocyte ratio in solid tumors: a systematic review and meta-analysis. Journal of the National Cancer Institute 2014;106: dju124.
36. Miguel CD, Serrano AJM, Núñez V, Estefanía K, Velayos M, Ferrero MM. Neutropthil-to-Lymphocyte Ratio as a Predictor of Postsurgical Intraabdominal Abscess in Children Operated for Acute Appendicitis. Front Pediatr 2019;29;7:424.
37. Yazici M, Ozkisacik S, Oztan M, Gürsoy H. Neutrophil/lymphocyte ratio in the diagnosis of childhood appendicitis. Turk J Pediatr 2010;52:400–3.
38. Erturk M, Cakmak HA, Surgit O, Celik O, Aksu HU, Akgul O. The predictive value of elevated neutrophil to lymphocyte ratio for long-term cardiovascular mortality in peripheral arterial occlusive disease. J Cardiol 2014;64(5):371-6.
39. Yuxiang Hu, Yi Cheng, Xiaoxuan Xu, Bo Yang, Feng Mei, Qiong Zhou. Pretreatment neutrophil-to-lymphocyte ratio predicts prognosis in patients with diabetic macular edema treated with ranibizumab. BMC Ophthalmology 2019;27;19(1):194.
40. Polderman KH. Mechanisms of action, physiological effects, and complications of hypothermia. Crit Care Med 2009;37:186–202.
41. Chen S, Yang Q, Chen G, Zhang JH. An update on inflammation in the acute phase of intracerebral hemorrhage. Transl Stroke Res 2015;6:4–8.
42. Qureshi AI, Mendelow AD, Hanley DF. Intracerebral haemorrhage. Lancet 2009;373:1632–44.
43. Gusdon AM, Gialdini G, Kone G, Baradaran H, Merkler AE, Mangat HS. Neutrophil-lymphocyte ratio and perihematomal edema growth in intracerebral hemorrhage. Stroke 2017;48:2589–92.

APA	Besir A, Tugcugil E, Akdogan A, M (2022). Neutrophil/lymphocyte ratio as a predictor of severe postoperative edema and ecchymosis in open rhinoplasty surgery. , 1568 - 1577. 10.17826/cumj.1134070
Chicago	Besir Ahmet,Tugcugil Ersagun,Akdogan Ali, Murat Neutrophil/lymphocyte ratio as a predictor of severe postoperative edema and ecchymosis in open rhinoplasty surgery. (2022): 1568 - 1577. 10.17826/cumj.1134070
MLA	Besir Ahmet,Tugcugil Ersagun,Akdogan Ali, Murat Neutrophil/lymphocyte ratio as a predictor of severe postoperative edema and ecchymosis in open rhinoplasty surgery. , 2022, ss.1568 - 1577. 10.17826/cumj.1134070
AMA	Besir A,Tugcugil E,Akdogan A, M Neutrophil/lymphocyte ratio as a predictor of severe postoperative edema and ecchymosis in open rhinoplasty surgery. . 2022; 1568 - 1577. 10.17826/cumj.1134070
Vancouver	Besir A,Tugcugil E,Akdogan A, M Neutrophil/lymphocyte ratio as a predictor of severe postoperative edema and ecchymosis in open rhinoplasty surgery. . 2022; 1568 - 1577. 10.17826/cumj.1134070
IEEE	Besir A,Tugcugil E,Akdogan A, M "Neutrophil/lymphocyte ratio as a predictor of severe postoperative edema and ecchymosis in open rhinoplasty surgery." , ss.1568 - 1577, 2022. 10.17826/cumj.1134070
ISNAD	Besir, Ahmet vd. "Neutrophil/lymphocyte ratio as a predictor of severe postoperative edema and ecchymosis in open rhinoplasty surgery". (2022), 1568-1577. https://doi.org/10.17826/cumj.1134070

APA	Besir A, Tugcugil E, Akdogan A, M (2022). Neutrophil/lymphocyte ratio as a predictor of severe postoperative edema and ecchymosis in open rhinoplasty surgery. Cukurova Medical Journal, 47(4), 1568 - 1577. 10.17826/cumj.1134070
Chicago	Besir Ahmet,Tugcugil Ersagun,Akdogan Ali, Murat Neutrophil/lymphocyte ratio as a predictor of severe postoperative edema and ecchymosis in open rhinoplasty surgery. Cukurova Medical Journal 47, no.4 (2022): 1568 - 1577. 10.17826/cumj.1134070
MLA	Besir Ahmet,Tugcugil Ersagun,Akdogan Ali, Murat Neutrophil/lymphocyte ratio as a predictor of severe postoperative edema and ecchymosis in open rhinoplasty surgery. Cukurova Medical Journal, vol.47, no.4, 2022, ss.1568 - 1577. 10.17826/cumj.1134070
AMA	Besir A,Tugcugil E,Akdogan A, M Neutrophil/lymphocyte ratio as a predictor of severe postoperative edema and ecchymosis in open rhinoplasty surgery. Cukurova Medical Journal. 2022; 47(4): 1568 - 1577. 10.17826/cumj.1134070
Vancouver	Besir A,Tugcugil E,Akdogan A, M Neutrophil/lymphocyte ratio as a predictor of severe postoperative edema and ecchymosis in open rhinoplasty surgery. Cukurova Medical Journal. 2022; 47(4): 1568 - 1577. 10.17826/cumj.1134070
IEEE	Besir A,Tugcugil E,Akdogan A, M "Neutrophil/lymphocyte ratio as a predictor of severe postoperative edema and ecchymosis in open rhinoplasty surgery." Cukurova Medical Journal, 47, ss.1568 - 1577, 2022. 10.17826/cumj.1134070
ISNAD	Besir, Ahmet vd. "Neutrophil/lymphocyte ratio as a predictor of severe postoperative edema and ecchymosis in open rhinoplasty surgery". Cukurova Medical Journal 47/4 (2022), 1568-1577. https://doi.org/10.17826/cumj.1134070