Diagnostic Value of Neutrophil to Lymphocyte Ratio for Assessing Obstructive Sleep Apnea Risk in Surgical Patients

Kaçmaz H., Akutay S., Kahraman H., Dal F., Sözüer E.

JOURNAL OF PERIANESTHESIA NURSING, no.6, 2023 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Publication Date: 2023
  • Doi Number: 10.1016/j.jopan.2023.07.015
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Scopus, CINAHL, MEDLINE, DIALNET
  • Keywords: diagnostic, neutrophil to lymphocyte ratio, obstructive sleep apnea, risk, surgery
  • Erciyes University Affiliated: Yes


Purpose: Obstructive sleep apnea (OSA) is an important risk factor leading to perioperative complications in surgical patients. Neutrophil-to-lymphocyte ratio (NLR) is an important biomarker of increasing interest in recent years, and is used in the determination of systemic inflammatory response. Design: The aim of this study was to evaluate the risk of OSA and the relationship between OSA risk and NLR in surgical patients. Methods: The study was conducted in a tertiary care hospital between November 2021 and May 2022. The cross-sectional study included 604 patients who underwent surgery. OSA risk was evaluated with the STOP-Bang questionnaire in the preoperative evaluation in all patients. NLR was calculated as the ratio of neutrophil count to lymphocyte count. Findings: According to the STOP-Bang questionnaire, 62.3% of the patients had a high risk of OSA in the preoperative period. Patients who were male, elderly, obese, had hypertension, diabetes, chronic lung disease, and heart disease and polypharmacy were at greater risk of OSA. Patients at high risk of OSA had significantly higher NLR than patients at low risk of OSA. (2.65 vs 2.92, P = .024). NLR of 2.40 or higher predicted OSA risk with 58.8% sensitivity and 51.0% specificity (AUC = 0.561) Conclusions: Most patients who were to undergo surgery had a high risk of OSA. NLR was higher in patients at high risk of OSA. Although the diagnostic efficacy is not high, NLR can be used to detect high OSA risk because it is a low-cost and easy to obtain biomarker. (c) 2023 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.