The Systemic Immune-Inflammation Index (SII) and The Neutrophil-to-Lymphocyte Ratio (NLR) as predictors of complications in patients after pancreatic surgery

Background Pancreatic surgeries are among the demanding operations that bring postoperative complications. The most common early postoperative complication is the pancreatic fistula, which is characterized by high morbidity and mortality. There are no non-invasive markers that can predict timely postoperative complications. Methods This prospective study focused on the occurrence of complications, classified according to the Clavien-Dindo classification, after resection of the pancreas in 71 patients. For each patient, the values of SII and NLR were determined before and after surgery. Subsequently, the relationship between the values and classes of complications, based on the Clavien-Dindo classification, was statistically analyzed. Results The areas under the ROC curves of SII were 0.9241 with 95% CI: 0.8396-1,000; 0.8248 with 95% CI: 0.7128-0,9368; 0.8091 with 95% CI 0.6229-0,9953, and 0.800 with 95% CI: 4943-1,000 in classes I-IV, respectively. The areas under the ROC curves of NLR were 0.9663 with 95% CI: 0.9200-1,000; 0.9096 with 95% CI: 0.8287-, 09904; 0.9167 with 95% CI 0.7979-1,000, and 1,000 with 95% CI: 1.000 in classes I-IV, respectively. Conclusion SII and NLR have proved to be suitable candidates for predicting postoperative complications after pancreatic surgery.