The Neutrophil Percentage to Albumin Ratio as an Independent Risk Factor for Severe Consciousness Disorders and...

This study investigated the relationship between the neutrophil percentage to albumin ratio (NPAR) and risks of severe consciousness disorders and in-hospital mortality after pulmonary surgery.

Patients undergoing pulmonary surgery and admitted to the intensive care unit were included in this retrospective study. Primary outcomes were severe consciousness disorders and in-hospital mortality. Cox proportional hazards models assessed associations between NPAR and these outcomes. Kaplan-Meier analysis demonstrated survival differences among patients with varying NPAR levels. Restricted cubic spline (RCS) analysis explored potential nonlinear associations between NPAR and outcomes. Subgroup analyses stratified by demographic characteristics, laboratory parameters, disease type, adjuvant therapy, and surgical type were performed to evaluate the consistency of results across different patient populations.

Among 717 included patients, severe consciousness disorder incidence was 40% and in-hospital mortality was 29%. NPAR demonstrated significant positive associations with both severe consciousness disorders (OR [95% CI]: 1.018 [1.006-1.031]; p = 0.004) and in-hospital mortality (OR [95% CI]: 1.018 [1.003-1.033]; p = 0.017). RCS analysis revealed a nonlinear relationship between NPAR and consciousness disorders, and an approximately linear relationship with in-hospital mortality. Subgroup analyses confirmed consistent findings across different patient populations.

NPAR is an independent predictor of severe consciousness disorders and in-hospital mortality following pulmonary surgery.