Preoperative platelet leukocyte ratio as an independent risk factor for postoperative outcomes in colorectal cancers.

3591 Background: Although preoperative platelet/leukocyte ratio (PLR) is a predictor of postoperative outcomes in various neoplasms, data is lacking for colorectal cancer (CRC). We hypothesized that elevated preoperative PLR would be an independent risk factor for postoperative complications and increased 30-day mortality in patients with surgically resected CRC. Methods: Patients undergoing resections for CRC were identified from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) from 2005 to 2016 dataset. Logistic regression models for 30-day morbidity and mortality for PLR ≤28.4 and >28.4 (calculated from ROC analyses) were completed. Univariate log-rank test, and multivariate Cox proportional hazards regression were used for time-to-event analyses and data are presented as odds/hazard ratio with confidence interval. Results: 98,398 patients were included in the study. Elevated PLR was an independent predictor of 30-day morbidity and mortality. Patients with high PLR were more likely to have a wound infection (1.022, 1.01-1.04), pneumonia (1.2, 1.17-1.23), require reintubation (1.23, 1.19-127), prolonged ventilation (1.31, 1.26-1.36), have renal insufficiency (1.17, 1.11-1.22), and have a postoperative myocardial infarction (1.23, 1.9-127). PLR value > 28.4 was among independent predictors of mortality (1.67, 1.47–1.87), along with the ASA class, age, perioperative use of steroids, serum albumin and INR. (Table). Conclusions: Elevated PLR is a significant preoperative risk factor for 30-day morbidity and mortality. PLR may be considered as a potential risk assessment tool that predicts postoperative outcome following CRC resections. Multivariate analysis. [Table: see text]