Association of immature platelets with perioperative complications in neurosurgery

Figures & data

Table I. Baseline characteristics.

Baseline characteristics	Overall (n = 391)	CDG 0–2 (n = 340)	CDG 3–5 (n = 51)	p
Age [years]	60 ± 16	59 ± 17	67 ± 13	.001
Male sex –n (%)	216 (55)	183 (54)	32 (63)	.241
Surgical procedure –n (%)
Spine surgery	241 (62)	209 (62)	31 (62)	.982
Craniotomy	101 (26)	90 (26)	11 (22)	.442
Tumor surgery	110 (28.1)	97 (29)	13 (26)	.693
Length of surgical procedure (min)	139 (90–204)	138 (88–200)	160 (92–245)	.065
Medical history at time of enrollment – n (%)
Arterial hypertension	180 (46)	152 (45)	27 (53)	.287
History of coronary artery disease	40 (10)	35 (10)	5 (10)	.904
History of myocardial infarction	20 (5)	17 (5)	3 (6)	.805
History of arrhythmia	47 (12.1)	39 (12)	8 (16)	.397
Asthma/COPD	41 (10.5)	36 (11)	5 (10)	.854
History of cerebrovascular disease	13 (3.3)	13 (4)	0 (0)	.154
Diabetes mellitus	45 (11.5)	35 (10)	9 (18)	.488
Chronic kidney disease	24 (6.1)	20 (6)	4 (8)	.594
Liver disease	34 (8.7)	26 (8)	8 (16)	.060
Dyslipidemia	79 (20.2)	66 (20)	12 (24)	.506
Tobacco use	80 (20.5)	67 (20)	13 (25)	.199
ASA physical status>2	77 (19.7)	61 (18)	16 (31)	.025

Categorical variables are given as number and percentage, continuous variables as mean ± standard deviation or as medians with interquartile ranges. CDG= Clavien Dindo Grade, COPD = chronic obstructive pulmonary disease, ASA = American Society of Anesthesiologists; Patients classified within the column “tumor surgery” could have been included in the spine surgery group, the craniotomy group or none of them. 11 of the 241 (5%) patients who underwent spine surgery were operated due to a tumor. In the craniotomy group 79 of the 101 patients (78%) underwent surgery due to a tumor disease.

Table II. Perioperative complications and length of stay data.

Postoperative complications	n (%)
Clavien Dindo Grade
0 – no complications	259 (66)
1 – any deviation from normal (without the need for further uncommon pharmacological treatment or intervention)	35 (9)
2 – more than routine pharmacological treatment and/or blood transfusion/parenteral nutrition	46 (12)
3 – surgical/radiological/interventional treatment needed	44 (11)
4 – Life-threatening complication (including CNS complications) requiring IMC/ICU care	3 (1)
5 – Death	4 (1)
Infection	30 (8)
Bleeding	20 (5)
Re-Surgery (30 days)	47 (12)
Hospital stay (days)	7 (4–13)
Discharge to:
home	300 (77)
physical rehab	56 (14)
secondary hospital	32 (8)

Events are given as total numbers (n) and percentage (%) of 391 patients. Data are referring to therapy-relevant complications and number of deaths in theperioperative period.

Figure 1. Box-Plot of IPF at the neurosurgical ward (24–72 hours post-operatively) stratified by surgical complications using Clavien Dindo Grade (CDG).

Figure 2. Box-Plot of H- IPF at the neurosurgical ward (24–72 hours post-operatively) stratified by surgical complications using Clavien Dindo Grade (CDG).

Table III. Immature platelet fraction and the association with therapy-orientated surgical complications.

Immature platelets				p
Preoperative	Overall (n = 391)	CDG 0–2 (n = 340)	CDG 3–5 (n = 51)
IPF	2.8 (1.9–4.4)	2.8 (1.9–4.4)	2.8 (2.2–4.7)	0.308
H-IPF	0.8 (0.5–1.3)	0.8 (0.5–1.3)	0.8 (0.5–1.4)	0.534
24-72 h after surgery	Overall (n = 301)	CDG 0–2 (n = 256)	CDG 3–5 (n = 45)
IPF	2.9 (1.9–4.5)	2.8 (1.9–4.3)	3.6 (2.5–4.9)	0.034
H-IPF	0.8 (0.5–1.3)	0.8 (0.5–1.2)	1.1 (0.7–1.4)	0.014
Immature platelets cutoff 24-72 h after surgery	Overall (n = 301)	CDG 0–2 (n = 256)	CDG 3–5 (n = 45)
IPF≥3.35%	124 (41)	100 (39)	24 (53)	0.070
H-IPF≥0.95%	122 (41)	97 (38)	25 (56)	0.025

Values are n(%); CDG= Clavien Dindo Grade, IPF: immature platelet fraction, H-IPF: highly fluorescent immature platelet fraction.

Figure 3. Receiver operating characteristic curve (ROC) for IPF at the neurosurgical ward (24–72 post-operatively).

Figure 4. Receiver operating characteristic curve (ROC) for H-IPF at the neurosurgical ward (24–72 post-operatively).

Data availability statement

The data that support the findings of this study are available on request from the corresponding author (IB). The data are not publicly available due to them containing information that could compromise research participant privacy/consent.