Predictive Value Of Preoperative LMR Values In Adverse Events After Endovascular Abdominal Aortic Aneurysm Repair

BackgroundAbdominal aortic aneurysm(AAA)is the most common aneurysm,and rupture can be life-threatening.Endovascular aneurysm repair(EVAR)is widely used in the treatment of abdominal aortic aneurysm due to its minimally invasive and effective treatment.However,the occurrence of adverse events after EVAR seriously affects the prognosis of patients,and its related factors need to be studied.Lymphocyte-monocyte ratio(LMR)is an inflammatory index that is easily obtained in clinical practice,and recently it has been found to be related to the prognosis of many diseases.Therefore,the correlation between LMR values and adverse events after EVAR in AAA patients deserves our further investigation.ObjectiveThe objective was to investigate the correlation between preoperative LMR value and adverse events after EVAR in AAA patients,and the predictive value of preoperative LMR value for adverse events after EVAR in AAA patients.MethodsThis study was a single-center,retrospective observational cohort study.According to the inclusion and exclusion criteria a total of 151 patients who underwent the first EVAR in our center from July 2018 to July 2021 were included.The baseline clinical data of the study population were obtained by reviewing the electronic medical records of the center.Study population follow-up data were obtained through electronic medical records,outpatient records,and telephone contact.The endpoint event of this study was postoperative adverse events after EVAR,including postoperative complications,all-cause death,aortic adverse events,cardiovascular adverse events and important organ perfusion adverse events.The incidence of adverse events after EVAR in AAA patients in our center was followed up.The correlation between LMR value and adverse events within 2 years after EVAR was analyzed.The receiver operating characteristic(ROC)curve was used to determine the predictive ability of LMR value for adverse events within 2 years after EVAR.A P value of less than 0.05 was considered statistically significant.Results(1)Univariate analysis showed that among the preoperative comorbidities,hypertension(P=0.037)and chronic kidney disease(P=0.015)had statistically significant differences in the incidence of postoperative adverse events.In preoperative laboratory tests,there were statistically significant differences in the incidence of postoperative adverse events between the groups of monocyte count(P=0.037),hemoglobin count(P=0.010),and LMR value(P=0.006).(2)Multivariate analysis showed that LMR value was an independent prognostic factor for adverse events after EVAR(P=0.049).(3)Multivariate Cox regression analysis showed that LMR<3.01 was an independent prognostic factor for adverse events within 2 years after surgery(P=0.002).ConclusionPreoperative LMR value is an independent prognostic factor for adverse events after EVAR in AAA patients.LMR≤3.01 can better predict the occurrence of adverse events within 2 years after surgery.