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Original Article
- Neurosurgery
- A low preoperative platelet-to-white blood cell ratio is associated with acute kidney injury following cerebral aneurysm treatment in South Korea
- Seung-Woon Lim, Woo-Young Jo, Hee-Pyoung Park
- Acute Crit Care. 2025;40(1):59-68. Published online February 21, 2025
- DOI: https://doi.org/10.4266/acc.003120
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- 3 Web of Science
- 3 Crossref
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Abstract
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Supplementary Material - Background
Inflammation is involved in the pathophysiology of postoperative acute kidney injury (AKI). We investigated whether preoperative platelet-to-white blood cell ratio (PWR), a novel serum biomarker of systemic inflammation, was associated with postoperative AKI following cerebral aneurysm treatment. We also compared the discrimination power of preoperative PWR with those of other preoperative systemic inflammatory indices in predicting postoperative AKI.
Methods
Perioperative data including preoperative systemic inflammatory indices and cerebral aneurysm-related variables were retrospectively analyzed in 4,429 cerebral aneurysm patients undergoing surgical clipping or endovascular coiling. Based on the cutoff value of preoperative PWR, patients were divided into the high PWR (≥39.04, n=1,924) and low PWR (<39.04, n=2,505) groups. After propensity score matching (PSM), 1,168 patients in each group were included in the data analysis. AKI was defined according to the Kidney Disease Improving Global Outcomes guidelines.
Results
Postoperative AKI occurred more frequently in the low PWR group than in the high PWR group before PSM (45 [1.8%] vs. 7 [0.4%], P<0.001) and after (17 [1.5%] vs. 5 [0.4%], P=0.016). A low preoperative PWR was predictive of postoperative AKI before PSM (odds ratio [95% CI], 3.93 [1.74–8.87]; P<0.001) and after (3.44 [1.26–9.34], P=0.016). Preoperative PWR showed the highest area under the curve for postoperative AKI (0.713 [0.644–0.782], P<0.001), followed by preoperative platelet-to-neutrophil ratio (0.694 [0.619–0.769], P<0.001), neutrophil percentage-to-albumin ratio (0.671 [0.592–0.750], P<0.001), white blood cell-to-hemoglobin ratio (0.665 [0.579–0.750], P<0.001), neutrophil-to-lymphocyte ratio (0.648 [0.569–0.728], P<0.001), and systemic inflammatory index (0.615 [0.532–0.698], P=0.004).
Conclusions
A low preoperative PWR was associated with postoperative AKI following cerebral aneurysm treatment. -
Citations
Citations to this article as recorded by
- Association between the platelet to white blood cell ratio and short term mortality in critically ill patients with atherosclerotic cardiovascular disease: A retrospective study and machine learning with external validation
Zhantao Cao, Hewei Qin, Yue Niu, Zilu Zhang, Guoju Dong
International Journal of Medical Informatics.2026; 209: 106267. CrossRef - Platelet-to-white blood cell ratio as a predictor of postoperative outcomes in acute type A aortic dissection: a single-center retrospective analysis
Biwen Yang, Yucheng Hou, Mingzhu Xu, Tingbo Jiang
Frontiers in Cardiovascular Medicine.2026;[Epub] CrossRef - A machine learning predictive model for acute kidney injury among aneurysmal subarachnoid hemorrhage patients
Ruoran Wang, Lingzhu Qian, Yunhui Zeng, Linrui Cai, Min He, Jianguo Xu, Yu Zhang
BMC Medical Informatics and Decision Making.2025;[Epub] CrossRef
- Association between the platelet to white blood cell ratio and short term mortality in critically ill patients with atherosclerotic cardiovascular disease: A retrospective study and machine learning with external validation
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