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The study enrolled 106 PBS patients in a tertiary hospital in Saudi Arabia and compared clinicodemographic features, laboratory parameters, and hematologic indices between prolonged and short hospitalization groups. Postoperative platelet-to-lymphocyte ratio and systemic inflammation index were higher in prolonged hospitalization. Receiver operating characteristic analysis defined postoperative cut-offs and logistic regression identified independent predictors, including elevated SII, transfusion need, and preoperative prothrombin time.",{"@graph":69,"@context":127},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/perioperative-predictors-of-delayed-recovery-after-pancreatic-and-biliary-surgeries-the-role-of-hematologic-indices/459704/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/perioperative-predictors-of-delayed-recovery-after-pancreatic-and-biliary-surgeries-the-role-of-hematologic-indices/459704.png","ImageObject",300,407,{"name":92,"@type":93},"Fahsai","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119,123],{"name":110,"@type":111,"acceptedAnswer":112},"What is the main objective of this study?","Question",{"text":113,"@type":114},"To determine perioperative factors and hematologic indices associated with delayed recovery after pancreatic and biliary surgeries (PBS).","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How were delayed recovery patients defined in the study?",{"text":118,"@type":114},"Patients were grouped by hospitalization duration: prolonged hospitalization corresponded to ≤5 days and short hospitalization to >5 days between January 2020 and April 2023.",{"name":120,"@type":111,"acceptedAnswer":121},"Which hematologic indices were linked to prolonged hospitalization?",{"text":122,"@type":114},"Postoperative platelet-to-lymphocyte ratio (PLR) and systemic inflammation index (SII) were significantly higher in patients with prolonged hospitalization.",{"name":124,"@type":111,"acceptedAnswer":125},"What did the regression analysis identify as independent predictors?",{"text":126,"@type":114},"Postoperative SII above 1073.17 was an independent predictor of prolonged hospitalization, alongside intraoperative blood transfusion requirement and preoperative prothrombin time.","https://schema.org",{"og:url":83,"og:type":129,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":131,"canonical":83},"index,follow",{"doc_id":133,"site_id":62},459704,1791038522,{"code":4,"msg":5,"data":136},{"doc_id":133,"user_id":137,"nickname":92,"user_avatar":138,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":139,"file_id":140,"file_url":141,"file_type":142,"file_size":143,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":44,"language":144,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":145,"faqs":146,"seo_title":147,"seo_description":67,"update_tm":148,"read_time":149,"preview_page_count":4},549768702563,"https://ap-avatar.wpscdn.com/avatar/8000c4aa63b76e948b?x-image-process=image/resize,m_fixed,w_180,h_180&k=1786536092046926083","Perioperative predictors of delayed recovery after pancreatic and biliary surgeries: The role of hematologic indices  \nSAGE Open Medicine Volume 14: 1–9 © The Author(s) 2026 Article reuse guidelines:  \n[sagepub.com/journals-permissions](sagepub.com/journals-permissions)[ ](sagepub.com/journals-permissions)[DOI: 10.1177/20503121251412725](DOI: 10.1177/20503121251412725)[ ](DOI: 10.1177/20503121251412725)[journals.sagepub.com/home/smo](journals.sagepub.com/home/smo)  \nMohmad H. Alsabani 1,2, Judy S. Alkhonain 1,2, Mohammed S. Aldosari 1,2, Shaimaa F. Alqawba 1, Aljawharah K. Almughaylith 1, Ohood H. Hakami 1,  \nLama A. Magrashi 1, Danah A. Alyami 1, Abdulaziz S. Alorafah2,3,4, Faraj K. Alenezi 1,2, Lafi H. Olayan 1,2 and Mohammed K. Al Harbi 1,2,4  \nAbstract  \nObjectives: Blood-derived immune-inflammatory markers have been identified as promising tools in many conditions. This study aims to determine the perioperative factors and hematologic indices associated with the occurrence of delayed recover after pancreatic and biliary surgeries (PBS).  \nMethods: Included in this study were 106 patients with PBS who were divided into prolonged hospitalization group ( ≤5 days; n = 48) and short hospitalization group ( >5 days; n = 58) between January 2020 and April 2023 in a tertiary hospital in Saudi Arabia. The clinico-demographic characteristics, laboratory parameters and blood-derived immune-inflammatory markers (neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio (PLR), systemic inflammatory index (SII), aggregate index of systemic inflammation, and systemic inflammatory response index) of the patients with and without prolonged hospitalization were compared by independent sample t-test, Mann–Whitney U-test, chi-square test, and Fisher’s exact test as appropriate. Receiver operating characteristic (ROC) analysis was used to establish a cut-off level of postoperative PLRand SII values to predict prolonged hospitalization. Perioperative factors associated with prolonged hospitalization were evaluated by univariable and stepwise multivariable logistic regression analyses.  \nResults: Of the 106 patients undergoing PBS, 48 patients (45.28%) had prolonged hospitalization. Both postoperative PLR and SII in patients with prolonged hospitalization were significantly higher than those in patients without. The ROC curve showed that the optimal cut-off value of postoperative SII to predict prolonged hospitalization was 1073.17, with 0.792 sensitivity and 0.483 specificity. In addition, the optimal cut-off value of postoperative PLR to predict prolonged hospitalization was 227.55, with 0.604 sensitivity and 0.638 specificity. Stepwise multivariate analysis showed that postoperative SII ( > 1073.17) was an independent predictor for prolonged hospitalization (odds ratio = 3.527, 95% confidence interval: 1.491–8.434, p = 0.004), together with intraoperative blood transfusion requirement and preoperative prothrombin time.  \nConclusions: Our findings demonstrated an association between the higher level of postoperative SII and delayed recovery, suggesting that it may be a useful parameter for identifying patients at risk of delayed recovery after PBS.  \nKeywords  \nPancreatic surgery, biliary surgery, hematological indices, immune-inflammatory makers, systemic inflammation index, NLR, PLR  \nReceived: 29 October 2025; accepted: 16 December 2025  \n1 Anesthesia Technology Department, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia  \n2King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia 3College of Sciences and Health Professions, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia  \n4Ministry of the National Guard – Health Affairs, Riyadh, Saudi Arabia  \nCorresponding author:  \nMohmad H. Alsabani, Anesthesia Technology Department, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11481, ","cbCaihCCLsJ63OB4","https://ap.wps.com/l/cbCaihCCLsJ63OB4","pdf",444831,"English","# Abstract\n## Objectives\n## Methods\n## Results\n## Conclusions\n# Introduction\n## Clinical context of PBS\n## Systemic inflammation and diagnostic markers","[{\"question\":\"What is the main objective of this study?\",\"answer\":\"To determine perioperative factors and hematologic indices associated with delayed recovery after pancreatic and biliary surgeries (PBS).\"},{\"question\":\"How were delayed recovery patients defined in the study?\",\"answer\":\"Patients were grouped by hospitalization duration: prolonged hospitalization corresponded to ≤5 days and short hospitalization to \\u003e5 days between January 2020 and April 2023.\"},{\"question\":\"Which hematologic indices were linked to prolonged hospitalization?\",\"answer\":\"Postoperative platelet-to-lymphocyte ratio (PLR) and systemic inflammation index (SII) were significantly higher in patients with prolonged hospitalization.\"},{\"question\":\"What did the regression analysis identify as independent predictors?\",\"answer\":\"Postoperative SII above 1073.17 was an independent predictor of prolonged hospitalization, alongside intraoperative blood transfusion requirement and preoperative prothrombin time.\"}]","Perioperative predictors of delayed recovery after pancreatic and biliary surgeries - The role of hematologic indices | PDF",1790756620,23]