Preoperative Inflammatory Indices Have Limited Predictive Value in Patients With Ruptured Abdominal Aortic Aneurysm.

Area of Science:

• Vascular Surgery
• Critical Care Medicine
• Hematology

Background:

• Ruptured abdominal aortic aneurysm (rAAA) is a critical surgical emergency with high mortality.
• Predictive markers for short-term outcomes in rAAA patients are crucial for clinical decision-making.

Purpose of the Study:

• To evaluate the predictive value of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic inflammatory response index (SIRI) for short-term morbidity and mortality in patients undergoing open repair of rAAA.

Main Methods:

• A single-center retrospective study included 74 patients undergoing rAAA open repair.
• Baseline inflammatory indices (NLR, PLR, SIRI) were calculated preoperatively.
• Univariate and multivariate analyses assessed associations with 30-day morbidity and short-term mortality.

Main Results:

• Inflammatory indices did not significantly differ based on clinical severity.
• Lower PLR was associated with 30-day morbidity (p=0.032).
• Non-survivors had significantly lower NLR, PLR, and SIRI (p<0.05).
• Modest predictive performance was observed for all indices via ROC analysis.
• Age, hemoglobin, PLR, and SIRI predicted 30-day mortality; NLR and PLR predicted 30-day morbidity.
• Preoperative loss of consciousness independently predicted 30-day morbidity (OR 0.173).

Conclusions:

• Preoperative inflammatory indices (NLR, PLR, SIRI) demonstrate limited predictive value for short-term outcomes in rAAA patients.
• Clinical and hemodynamic parameters, alongside inflammatory markers, are essential for comprehensive outcome assessment.
• Clinical severity remains the primary determinant of early outcomes in rAAA.