Immunocite-Derived Ratios Can Preoperatively Predict the Risk for Surgical Complications when Artificial Neural Networks Are Used for Analysis

This study aimed to comparatively evaluate the prognostic preoperative utility of key peripheral blood components and their derived ratios—the systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR)—i...

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Main Authors: Stefan PATRASCU, Georgiana-Maria COTOFANA-GRAURE, Mircea-Sebastian ŞERBĂNESCU, Valeriu SURLIN
Format: Article
Language:English
Published: Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca 2025-05-01
Series:Applied Medical Informatics
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Online Access:https://ami.info.umfcluj.ro/index.php/AMI/article/view/1140
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author Stefan PATRASCU
Georgiana-Maria COTOFANA-GRAURE
Mircea-Sebastian ŞERBĂNESCU
Valeriu SURLIN
author_facet Stefan PATRASCU
Georgiana-Maria COTOFANA-GRAURE
Mircea-Sebastian ŞERBĂNESCU
Valeriu SURLIN
author_sort Stefan PATRASCU
collection DOAJ
description This study aimed to comparatively evaluate the prognostic preoperative utility of key peripheral blood components and their derived ratios—the systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR)—in conjunction with artificial neural network analysis for predicting adverse postoperative outcomes in patients with colorectal cancer. A retrospective analysis was conducted on 288 patients who underwent elective radical surgery for colorectal cancer over the past seven years. Preoperative values of SII, NLR, LMR, and PLR were assessed in relation to postoperative complications, with particular emphasis on their predictive accuracy for anastomotic leakage. A feed-forward fully connected multilayer perceptron (MLP) network was trained and tested alongside conventional statistical methods to evaluate the predictive performance of these biomarkers in terms of sensitivity and specificity. Statistically significant differences and moderate correlations were identified for SII and NLR in predicting the incidence and severity of anastomotic leakage and postoperative complications. In contrast, no significant associations were observed between LMR, PLR, and these outcomes. The MLP network demonstrated superior predictive performance, yielding higher sensitivity (0.81 ± 0.06; 0.77 ± 0.03; 0.69 ± 0.11) and specificity (0.82 ± 0.13; 0.68 ± 0.05; 0.9 ± 0.07) across all evaluated tasks. These findings suggest that preoperative SII and NLR serve as modest prognostic indicators for anastomotic leakage and overall postoperative morbidity. Furthermore, the application of artificial neural networks enhances predictive accuracy in preoperative risk assessment for both overall morbidity and anastomotic leakage rates.
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spelling doaj-art-6ad1d6e08d5c40cbbe551ccf27b141ea2025-08-20T03:45:15ZengIuliu Hatieganu University of Medicine and Pharmacy, Cluj-NapocaApplied Medical Informatics2067-78552025-05-0147Suppl. 1Immunocite-Derived Ratios Can Preoperatively Predict the Risk for Surgical Complications when Artificial Neural Networks Are Used for AnalysisStefan PATRASCU0Georgiana-Maria COTOFANA-GRAURE1Mircea-Sebastian ŞERBĂNESCU2Valeriu SURLIN3University of Medicine and Pharmacy of Craiova, RomaniaUniversity of Medicine and Pharmacy of CraiovaUniversity of Medicine and Pharmacy of CraiovaUniversity of Medicine and Pharmacy of Craiova This study aimed to comparatively evaluate the prognostic preoperative utility of key peripheral blood components and their derived ratios—the systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR)—in conjunction with artificial neural network analysis for predicting adverse postoperative outcomes in patients with colorectal cancer. A retrospective analysis was conducted on 288 patients who underwent elective radical surgery for colorectal cancer over the past seven years. Preoperative values of SII, NLR, LMR, and PLR were assessed in relation to postoperative complications, with particular emphasis on their predictive accuracy for anastomotic leakage. A feed-forward fully connected multilayer perceptron (MLP) network was trained and tested alongside conventional statistical methods to evaluate the predictive performance of these biomarkers in terms of sensitivity and specificity. Statistically significant differences and moderate correlations were identified for SII and NLR in predicting the incidence and severity of anastomotic leakage and postoperative complications. In contrast, no significant associations were observed between LMR, PLR, and these outcomes. The MLP network demonstrated superior predictive performance, yielding higher sensitivity (0.81 ± 0.06; 0.77 ± 0.03; 0.69 ± 0.11) and specificity (0.82 ± 0.13; 0.68 ± 0.05; 0.9 ± 0.07) across all evaluated tasks. These findings suggest that preoperative SII and NLR serve as modest prognostic indicators for anastomotic leakage and overall postoperative morbidity. Furthermore, the application of artificial neural networks enhances predictive accuracy in preoperative risk assessment for both overall morbidity and anastomotic leakage rates. https://ami.info.umfcluj.ro/index.php/AMI/article/view/1140Artificial Neural NetworkBiomarkersInflammationPrognostic Factors
spellingShingle Stefan PATRASCU
Georgiana-Maria COTOFANA-GRAURE
Mircea-Sebastian ŞERBĂNESCU
Valeriu SURLIN
Immunocite-Derived Ratios Can Preoperatively Predict the Risk for Surgical Complications when Artificial Neural Networks Are Used for Analysis
Applied Medical Informatics
Artificial Neural Network
Biomarkers
Inflammation
Prognostic Factors
title Immunocite-Derived Ratios Can Preoperatively Predict the Risk for Surgical Complications when Artificial Neural Networks Are Used for Analysis
title_full Immunocite-Derived Ratios Can Preoperatively Predict the Risk for Surgical Complications when Artificial Neural Networks Are Used for Analysis
title_fullStr Immunocite-Derived Ratios Can Preoperatively Predict the Risk for Surgical Complications when Artificial Neural Networks Are Used for Analysis
title_full_unstemmed Immunocite-Derived Ratios Can Preoperatively Predict the Risk for Surgical Complications when Artificial Neural Networks Are Used for Analysis
title_short Immunocite-Derived Ratios Can Preoperatively Predict the Risk for Surgical Complications when Artificial Neural Networks Are Used for Analysis
title_sort immunocite derived ratios can preoperatively predict the risk for surgical complications when artificial neural networks are used for analysis
topic Artificial Neural Network
Biomarkers
Inflammation
Prognostic Factors
url https://ami.info.umfcluj.ro/index.php/AMI/article/view/1140
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AT georgianamariacotofanagraure immunocitederivedratioscanpreoperativelypredicttheriskforsurgicalcomplicationswhenartificialneuralnetworksareusedforanalysis
AT mirceasebastianserbanescu immunocitederivedratioscanpreoperativelypredicttheriskforsurgicalcomplicationswhenartificialneuralnetworksareusedforanalysis
AT valeriusurlin immunocitederivedratioscanpreoperativelypredicttheriskforsurgicalcomplicationswhenartificialneuralnetworksareusedforanalysis