Neutrophil-to-lymphocyte and Platelet-to-lymphocyte Ratio in Predicting the Incidence of Nausea and Vomiting

The Effectiveness of Preoperative Neutrophil-to-lymphocyte and Platelet-to-lymphocyte Ratio in Predicting the Incidence of Nausea and Vomiting After Total Knee Replacement in Hemophilia A

By comparing the incidence of PONV, the dosage of postoperative antiemetic drugs, the postoperative VAS score and the utilization rate of PCIA of hemophilia A patients in the NLR≥2 and NLR<2 groups, investigators could find out the high value in the diagnosis of hemophilia A, which is helpful to guide the clinical diagnosis and treatment of hemophilia A.

Study Overview

• Status: Not yet recruiting
• Conditions: Hemophilia A

Detailed Description

Hemophilia arthropathy is a debilitating complication of hemophilia that occurs primarily in severe forms with recurrent spontaneous intra-articular hemorrhage, with the knee being the most commonly affected joint. Currently, total knee arthroplasty is the standard treatment for end-stage hemophilic arthropathy. Due to the special disease of hemophilia, general anesthesia is often chosen as the preferred anesthesia method, and the risk of bleeding is lower than that of neuraxial anesthesia. However, 20 to 30 percent of surgical patients suffer from post-operative nausea and vomiting after general anesthesia. Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio have been suggested as parameters for the diagnosis and follow-up of inflammatory diseases, and inflammation has been found to increase the risk of PONV. However, for patients with hemophilia, no information is currently available on the relationship between the two. In this study, investigators intend to retrospectively analyze the clinical data of patients with hemophilia A in our hospital, explore the clinical value of preoperative NLR and PLR in predicting nausea and vomiting after TKA.

• Study Type: Observational
• Enrollment (Anticipated): 120

Contacts and Locations

• Study Contact: Name: Yuelan Wang; Phone Number: 15953105780; Email: wyldgf@163.com

Study Locations

• China
  • Shandong
    • Jinan, Shandong, China, 250000
      • Shandong Provincial Qianfoshan Hospital, The First Hospital affiliated of Shandong First Medical University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 70 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: Male

• Sampling Method: Non-Probability Sample

Study Population

Hemophilia A patients who underwent single knee replacement under general anesthesia in the First Affiliated Hospital of Shandong First Medical University from March 2018 to February 2022

Description

Inclusion Criteria:

1. The patients with hemophilia A undergoing unilateral total knee arthroplasty.
2. The age of the patients ranged from 18 to 70 years.
3. American Society of Anesthesiologists is graded as I~III
4. No history of mental illness
5. No history of antiemetic and anticholinergic drugs.
6. No history of serious gastrointestinal diseases.

Exclusion Criteria:

1. Patients who have received long-term steroid treatment
2. Patients who need more than 2.5 mg neostigmine to reverse muscle relaxants
3. Patients with previous malignant tumor, malabsorption, morbid obesity, hypogonadism, thyroid and parathyroid diseases and autoimmune diseases.

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Retrospective

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Incidence of PONV in patients with hemophilia A receiving general anesthesia orders for knee arthroplasty	PONV was defined as the onset of nausea or vomiting within 24 hours after surgery	up to 24 hours after surgery

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The amount of postoperative antiemetics	antiemetics includes ondansetron, metoclopramide, dexamethasone	up to 24 hours after surgery
VAS score after returning to the ward	postoperative pain can be evaluated using the visual analogue scale (0-10 score, 0: no pain, 10: worst imaginable pain).	immediately after returning to the ward
Usage of PCIA	the use of postoperative patient controlled intravenous analgesia	up to 24 hours after surgery

Collaborators and Investigators

• Sponsor: Qianfoshan Hospital
• Investigators: Principal Investigator: Yuelan Wang, China, Shandong Qianfoshan Hospital

Study record dates

Study Major Dates

• Study Start (Anticipated): December 15, 2022
• Primary Completion (Anticipated): January 20, 2023
• Study Completion (Anticipated): February 20, 2023

Study Registration Dates

• First Submitted: November 17, 2022
• First Submitted That Met QC Criteria: December 2, 2022
• First Posted (Actual): December 5, 2022

Study Record Updates

• Last Update Posted (Actual): December 5, 2022
• Last Update Submitted That Met QC Criteria: December 2, 2022
• Last Verified: December 1, 2022

More Information

Terms related to this study

• Keywords: Platelet; Neutrophil; Hemophilia; Lymphocyte; Post-operative nausea and vomiting
• Additional Relevant MeSH Terms: Hematologic Diseases; Signs and Symptoms, Digestive; Blood Coagulation Disorders, Inherited; Coagulation Protein Disorders; Hemorrhagic Disorders; Genetic Diseases, Inborn; Blood Coagulation Disorders; Hemophilia A; Nausea; Vomiting
• Other Study ID Numbers: neutrophil-to-lymphocyte ratio

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No