NLR value and IL-18 level and their clinical significance in patients with deep vein thrombosis after receiving the surgery for spinal degeneration

摘要

Objective: To investigate the value of the neutrophil-to-lymphocyte ratio (NLR) and Interleukin 18 (IL-18) level in patients with deep vein thrombosis after receiving surgery for spinal degeneration; and we explore their significance in clinical practice. Methods: This study was conducted in 296 patients who were treated in our hospital for spinal degeneration. After surgery, these patients were followed up for 1 month. After performing the color Doppler ultrasound examination, patients were divided into the thrombus group (n = 72) and the non-thrombus group (n = 224) based on the occurrence of deep vein thrombosis. Baseline data, NLR values and IL-18 levels before surgery, and at 1, 3, 5, and 7 days after surgery were compared between the two groups. Logistic regression analysis was implemented to analyze the risk factors for postoperative deep vein thrombosis. Patients in the thrombosis group were allocated to the mild, moderate, and severe group on the basis of the degree of thrombosis. NLR values and IL-18 levels at 3 days after surgery were compared among the three groups. The correlations between both NLR value and IL-18 level and the severity of deep vein thrombosis were analyzed with Pearson correlation. Receiver operating characteristic curve was used to assess the clinical value of NLR value and IL-18 level at 3 days after surgery in predicting postoperative deep vein thrombosis. Results: There were significant differences concerning age, the history of diabetes, and obesity between the two groups (all P<0.05). NLR values and IL-18 levels in both groups after surgery were increased when compared with before surgery (all P<0.01). In addition, NLR values and IL-18 levels reached a peak at 3 days after surgery. Compared with the non-thrombus group, NLR values and IL-18 levels in the thrombus group at 1, 3, 5, and 7 days after surgery were increased (all P<0.01). NLR value and IL-18 level in the thrombosis group at 3 days after surgery were increased with a worsened degree of thrombosis. In other words, both NLR value and IL-18 level were positively correlated with the degree of deep vein thrombosis. The results of logistic regression analysis displayed that age ≥60 years old, body mass index ≥23 kg/m2, NLR value >4.34%, and IL-18 level >115.71 ng/mL were independent risk factors for postoperative deep vein thrombosis. The results of the ROC curve showed that the area under curves, which represent the formation of postoperative deep vein thrombosis, were above 0.7 when using NLR value and IL-18 level at 3 days after surgery (both P<0.001). Conclusion: Compared with the non-thrombus group, NLR value and IL-18 level in the thrombosis group after receiving surgery for spinal degeneration are significantly increased. In addition, the more severe the thrombosis is, the higher the NLR value and IL-18 level at 3 days after surgery. Therefore, NLR value and IL-18 level at 3 days after surgery have certain clinical value in predicting postoperative deep vein thrombosis and prognosis.