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Updated: Nov 11, 2025
Microfluidics in Assessing Platelet Function
Published on: November 8, 2024
Platelet to Lymphocyte Ratio Associated with Prolonged Hospital Length of Stay Postpeptic Ulcer Perforation Repair:
Omer Al-Yahri1, Tamer Saafan2, Husham Abdelrahman3
1Department of Surgery, Acute Care Surgery, Hamad Medical Corporation, Doha, Qatar.
Insights
High preoperative platelet-to-lymphocyte ratio (P/LR) indicates a longer hospital stay for patients undergoing surgery for perforated peptic ulcers (PPU). This finding helps predict recovery time after PPU surgery.
Area of Science:
- Surgical Gastroenterology
- Inflammatory Markers
- Clinical Outcomes Prediction
Background:
- The predictive value of the platelet-to-lymphocyte ratio (P/LR) in perforated peptic ulcer (PPU) patients remains underexplored.
- Understanding predictors of hospital length of stay (HLOS) is crucial for managing PPU cases.
Purpose of the Study:
- To investigate the association between the P/LR ratio and HLOS in surgically treated PPU patients.
- To identify P/LR as a potential predictor for prolonged hospitalization.
Main Methods:
- Retrospective observational study of 152 adult PPU patients treated surgically.
- Patients grouped by HLOS (<1 week vs. >1 week).
- Receiver operating characteristic (ROC) curve analysis to determine cutoff values for predicting prolonged hospitalization.
Main Results:
- A higher P/LR ratio was significantly associated with prolonged HLOS (>1 week).
- Optimal P/LR cutoff of 311.2 predicted prolonged hospitalization with 93% negative predictive value.
- Older age and lower lymphocyte count also correlated with longer hospital stays.
Conclusions:
- Elevated preoperative P/LR is a significant predictor of prolonged HLOS in surgically repaired PPU.
- Further multicenter studies are warranted to validate these findings.
Background:
The predictive role of platelet to lymphocyte ratio (P/LR) in patients with perforated peptic ulcer (PPU) is not well-studied. We aimed to investigate the association between the P/LR ratio and the hospital length of stay (HLOS) for surgically treated PPU.
Method:
This is a retrospective observational study for surgically treated adult cases of PPU at Hamad Medical Corporation during the period from January 2012 to August 2017. Patients were categorized into two groups based on their HLOS (I week). The receiver operating characteristic (ROC) curve was plotted to determine the cutoff value for lymphocyte count, neutrophil to lymphocyte ratio, and P/LR ratio for predicting the prolonged hospitalization.
Results:
One hundred and fifty-two patients were included in the study. The majority were young males. The mean age was 38.3 ± 12.7 years. Perforated duodenal ulcer (139 patients) exceeded perforated gastric ulcer (13 patients). The HLOS > 1 week was observed in 14.5% of cases. Older age (p = 0.01), higher preoperative WBC (p = 0.03), lower lymphocyte count (p = 0.01), and higher P/LR ratio (p = 0.005) were evident in the HLOS > 1 week group. The optimal cutoff value of P/LR was 311.2 with AUC 0.702 and negative predictive value of 93% for the prediction of prolonged hospitalization. Two patients died with a mean P/LR ratio of 640.8 ± 135.5 vs. 336.6 ± 258.9 in the survivors.
Conclusion:
High preoperative P/LR value predicts prolonged HLOS in patients with repaired perforated peptic ulcer. Further larger multicenter studies are needed to support the study findings.
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