Neutrophil-Lymphosit Rasio as a Pedictor Outcome of Elective Pediatric Surgery for Clean and Clean Contaminated 
Operation: Single Centre Study

Abstract
Background : Neutrofil-Limfosit Ratio (NLR) is a simple indicator for study inflammatory status easily in patient. An increasing value of neutrophils and decreasing value of lymphocytes is a physiological response in the immune system to systemic inflammation.
Methods : This study was an analytical observational quantitative study using a prospective cohort approach, involving 51 patients pediatric surgery from age ?1 months until ?18 years who had done elective operation clean and clean contaminated criteria and after 6 hours operation, the subject had differential counted blood examination. Then we checked the outcome after first, third and seventh day after surgery, whether the condition improved (without complication) or worsen conditions (with complication)
Results : From the total 51 patients, there was a significant result for gender in variable post operation in this research (OR=3.968; 95%CI=1.160- 13.579;p =0,028), whether female patient were more risky 3,968 times to become worsen condition (with complication) than male patient. 34 patients with RNL? 5 consist of consists of 25 patients (73.5%) got improved condition (without complication), whether 17 patients who got worsen condition (with complication) with RNL >5 consist of 12 patients (70,6%). Sensitivity rate was 0,735, and specificity rate was 0,706 and prevalence ratio was 1,716. From this research we got RNL>5 (OR=6.667; 95%CI=1.832-24.264; p=0,004) were more risky 6.667 times to become worsen (with complication) than RNL?5. From chi square result we got p value=0,003 (p<0>Conclusions : There was a significant relationship between RNL and outcome operation in pediatric surgery age ?1 month- ?18 years that was done elective operation with clean and clean contaminated surgery criteria, whether normal value of NLR would give improved outcome (without complication).