Spitalul Clinic de Ortopedie Foișor, Bucharest, Romania.
'Victor Babes' University of Medicine and Pharmacy, Timisoara, Romania.
Int Orthop. 2019 Jul;43(7):1567-1572. doi: 10.1007/s00264-019-04305-1. Epub 2019 Feb 6.
The neutrophil to lymphocyte ratio (NLR) is a simple predictor used in oncology and cardiology. We aimed to analyze the NLR profile of patients with diaphyseal fractures of the humerus, femur, and tibia.
We performed a cross-sectional, consecutive-case population-based study including 148 patients (41.9% men respectively 58.1% women) with humeral (23.0%), femoral (30.4%), and tibial (46.6%) diaphyseal fractures, admitted for surgical treatment in our level 1 trauma centre over two years.
The differences in NLR between the studied subgroups were not significant (p = 0.067), the highest value being observed in patients with femoral fracture (5.6) in contrast to patients with humeral fracture (4). In the global cohort, there was a significantly positive correlation between NLR and PLR (platelet to lymphocyte ratio; Spearman's r = 0.595; p < 0.001). The stratified subgroup analysis found significant association between NLR and duration of admission only for patients with femoral fracture (Spearman's r = - 0.308; p < 0.001). When compared with controls, all three fracture types had significantly higher neutrophil numbers and NLR and lower thrombocyte numbers.
NLR are elevated in femur diaphyseal fractures compared with tibia and humerus, up to cut-off values with negative prediction of outcome in malignancy and cardiovascular patients. Increased NLR are predictive of longer hospital admissions for femur fractures.
中性粒细胞与淋巴细胞比值(NLR)是一种在肿瘤学和心脏病学中常用的简单预测指标。我们旨在分析肱骨干、股骨干和胫骨干骨折患者的 NLR 特征。
我们进行了一项横断面、连续病例的基于人群的研究,纳入了 148 名(41.9%为男性,58.1%为女性)肱骨干(23.0%)、股骨干(30.4%)和胫骨干(46.6%)骨折患者,这些患者在我们的 1 级创伤中心接受手术治疗,时间为两年。
研究亚组之间 NLR 的差异无统计学意义(p=0.067),股骨干骨折患者的 NLR 值最高(5.6),与肱骨干骨折患者的 NLR 值(4)相比。在整体队列中,NLR 与 PLR(血小板与淋巴细胞比值;Spearman's r=0.595;p<0.001)之间存在显著正相关。分层亚组分析发现,仅在股骨干骨折患者中,NLR 与住院时间之间存在显著相关性(Spearman's r=-0.308;p<0.001)。与对照组相比,三种骨折类型的中性粒细胞数和 NLR 均显著升高,血小板数显著降低。
与胫骨和肱骨骨折相比,股骨干骨折患者的 NLR 升高,达到了恶性肿瘤和心血管疾病患者不良预后的预测截断值。NLR 升高可预测股骨干骨折患者的住院时间延长。