Aged Care Department, Illawarra and Shoalhaven Local Health District, Wollongong Hospital, Wollongong, New South Wales, Australia.
BMC Musculoskelet Disord. 2023 Mar 25;24(1):227. doi: 10.1186/s12891-023-06211-5.
Neutrophil to Lymphocyte Ratio (NLR) is a simple biomarker of systemic inflammatory response. We investigated predictability of NLR for early adverse outcome after surgery for hip fracture in elderly population.
We reviewed a total of 971 elderly patients with hip fracture who underwent emergency surgery between January 2017 and July 2020 in the Department of Orthopaedics Surgery at the Wollongong Hospital. After considering exclusion criteria, data from a total of 834 patients included in our study. Socio-demographic data, NLR in admission, updated Charlson comorbidity index (uCCI), biochemical markers, mortality rate and 15 short term post-operative complications were collected to determine predictability of NLR for post-operative complications and mortality.
After hip surgery, Hospital in-patient case fatality rate was 3.7% (31). In addition, 63.1% (511) of the patients had at least one complication or more. Logistic regression demonstrated that raised NLR (P-value < 0.001, OR 1.05) and uCCI≥4 (P-Value < 0.001, OR 1.75) are associated with post-operative complications. Moreover, decreased haemoglobin was associated with adverse effects (P-value < 0.001, OR 0.97). No association was found for any of these variables with in-patient mortality except for albumin (P-value: 0.03). In addition, despite significant association, ROC analyses showed a low predictability for each of the above variables including NLR (AUC 0.59) for post-operative complications.
Despite significant association, NLR was unable to prognosticate early adverse outcomes. However, it can be considered as a risk factor in admission for postoperative complications in combination with other risk factors and clinical context.
中性粒细胞与淋巴细胞比值（NLR）是全身炎症反应的简单生物标志物。我们研究了 NLR 对老年髋部骨折患者手术后早期不良结局的预测能力。
我们回顾了 2017 年 1 月至 2020 年 7 月期间在 Wollongong 医院骨科接受紧急手术的 971 名老年髋部骨折患者的全部数据。在考虑排除标准后，共有 834 名患者的数据纳入本研究。收集了社会人口统计学数据、入院时的 NLR、更新的 Charlson 合并症指数（uCCI）、生化标志物、死亡率和 15 个短期术后并发症，以确定 NLR 对术后并发症和死亡率的预测能力。
髋手术后，住院病死率为 3.7%（31 例）。此外，63.1%（511 例）的患者至少有一种或多种并发症。Logistic 回归表明，升高的 NLR（P 值<0.001，OR 1.05）和 uCCI≥4（P 值<0.001，OR 1.75）与术后并发症相关。此外，血红蛋白降低与不良影响相关（P 值<0.001，OR 0.97）。除白蛋白（P 值：0.03）外，这些变量与住院死亡率均无相关性。此外，尽管存在显著相关性，但 ROC 分析显示，包括 NLR（术后并发症的 AUC 为 0.59）在内的上述变量对早期不良结局的预测能力较低。
尽管存在显著相关性，但 NLR 无法预测早期不良结局。然而，它可以被认为是术后并发症入院时的一个危险因素，结合其他危险因素和临床情况进行考虑。
