Neutrophil-to-lymphocyte ratio is effective prognostic indicator for post-amputation patients with critical limb ischemia

Qi Wang, Han Liu, Siqiao Sun, Zhihua Cheng, Yang Zhang, Xiwei Sun, Zhongying Wang, Shuai Wang

Abstract


Objectives: To confirm whether neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are indicators for the prognosis of post-amputation patients with critical limb ischemia (CLI).

 

Methods: In this retrospective observational study a total 270 post-amputation patients with CLI were included between January 2010 and December 2014 in the First Hospital of Jilin University, Changchun, China. The neutrophil and lymphocyte counts were recorded before amputations. Neutrophil-to-lymphocyte ratio was calculated and NLR ≥8.08 was defined as elevated. Logistic regression analysis was conducted to test the prognostic value.

 

Results: According to the statistical analysis, it was indicated that NLR ≥8.08 (odds ratio [OR]: 26.228, 95% confidence interval [CI]: 5.801-118.583, p less than 0.001), PLR ≥237.14 (OR: 3.464, 95% CI: 1.289-9.308, p=0.014) and coronary heart disease (OR: 2.739, 95% CI: 1.060-7.082, p=0.038) were the independent prognostic indicators for the patients.

 

Conclusion: Neutrophil-to-lymphocyte ratio, PLR, and coronary heart disease are independent prognostic indicators for post-amputation patients with CLI.

 

Saudi Med J 2017; Vol. 38 (1): 24-29

doi: 10.15537/smj.2017.1.15936


How to cite this article:


Wang Q, Liu H, Sun S, Cheng Z, Zhang Y, Sun X, Wang Z, Wang S. Neutrophil-to-lymphocyte ratio is effective prognostic indicator for post-amputation patients with critical limb ischemia. Saudi Med J. 2017 Jan;38(1):24-29. doi: 10.15537/smj.2017.1.15936.


Keywords


Neutrophil to lymphocyte ratio; critical limb ischemia; amputation; prognosis

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References


Nehler MR, Duval S, Diao L, Annex BH, Hiatt WR, Rogers K, et al. Epidemiology of peripheral arterial disease and critical limb ischemia in an insured national population. J Vasc Surg 2014; 60: 686-695.

Miyahara T, Suhara M, Nemoto Y, Shirasu T, Haga M, Mochizuki Y, et al. Long-term results of treatment for critical limb ischemia. Ann Vasc Dis 2015; 8: 192-197.

Chang SH, Tsai YJ, Chou HH, Wu TY, Hsieh CA, Cheng ST, et al. Clinical predictors of long-term outcomes in patients with critical limb ischemia who have undergone endovascular therapy. Angiology 2014; 65: 315-322.

Hankey GJ, Norman PE, Eikelboom JW. Medical treatment of peripheral arterial disease. JAMA 2006; 295: 547-553.

Lo RC, Bensley RP, Dahlberg SE, Matyal R, Hamdan AD, Wyers M, et al. Presentation, treatment, and outcome differences between men and women undergoing revascularization or amputation for lower extremity peripheral arterial disease. J Vasc Surg 2014; 59: 409-418.

Won SH, Chung CY, Park MS, Lee T, Sung KH, Lee SY, et al. Risk factors associated with amputation-free survival in patient with diabetic foot ulcers. Yonsei Med J 2014, 55: 1373-1378.

Fei YF, Wang C, Chen DW, Li YH, Lin S, Liu GJ, et al. Incidence and risk factors of amputation among inpatients with diabetic foot. Natl Med J China 2012; 92: 1686-1689.

Templeton AJ, McNamara MG, Seruga B, Vera-Badillo FE, Aneja P, Ocana A, et al. Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: a systematic review and meta-analysis. J Natl Cancer Inst 2014; 106: dju124.

Zhou X, Du Y, Huang Z, Xu J, Qiu T, Wang J, et al. Prognostic value of PLR in various cancers: a meta-analysis. PLoS One 2014; 9: e101119.

Conte MS, Geraghty PJ, Bradbury AW, Hevelone ND, Lipsitz SR, Moneta GL, et al. Suggested objective performance goals and clinical trial design for evaluating catheter-based treatment of critical limb ischemia. J Vasc Surg 2009; 50: 1462-1473.

Goodney PP, Schanzer A, Demartino RR, Nolan BW, Hevelone ND, Conte MS, et al. Vascular Study Group of New England. Validation of the Society for Vascular Surgery’s objective performance goals for critical limb ischemia in everyday vascular surgery practice. J Vasc Surg 2011; 54: 100-108.

Vierthaler L, Callas PW, Goodney PP, Schanzer A, Patel VI, Cronenwett J, et al. Determinants of survival and major amputation after peripheral endovascular intervention for critical limb ischemia. J Vasc Surg 2015; 62: 655-664.

Curran T, Zhang JQ, Lo RC, Fokkema M, McCallum JC, Buck DB, et al. Risk factors and indications for readmission after lower extremity amputation in the American College of Surgeons National Surgical Quality Improvement Program. J Vasc Surg 2014; 60: 1315-1324.

Nunez J, Nunez E, Bodi V, Sanchis J, Minana G, Mainar L, et al. Usefulness of the neutrophil to lymphocyte ratio in predicting long-term mortality in ST segment elevation myocardial infarction. Am J Cardiol 2008; 101: 747-752.

Kishi Y, Kopetz S, Chun YS, Palavecino M, Abdalla EK, Vauthey JN. Blood neutrophil-to-lymphocyte ratio predicts survival in patients with colorectal liver metastases treated with systemic chemotherapy. Ann Surg Oncol 2009; 16: 614-622.

Shimada H, Takiguchi N, Kainuma O, Soda H, Ikeda A, Cho A, et al. High preoperative neutrophil-lymphocyte ratio predicts poor survival in patients with gastric cancer. Gastric Cancer 2010; 13: 170-176.

Gunay E, Sarınc Ulasli S, Akar O, Ahsen A, Gunay S, Koyuncu T, et al. Neutrophil-to-lymphocyte ratio in chronic obstructive pulmonary disease: a retrospective study. Inflammation 2014; 37: 374-380.

Pinato DJ, Mauri FA, Ramakrishnan R, Wahab L, Lloyd T, Sharma R. Inflammation-based prognostic indices in malignant pleural mesothelioma. J Thorac Oncol 2012; 7: 587-594.

Wang DS, Luo HY, Qiu MZ, Wang ZQ, Zhang DS, Wang FH, et al. Comparison of the prognostic values of various inflammation based factors in patients with pancreatic cancer. Med Oncol 2012; 29: 3092-3100.

Pinato DJ, Shiner RJ, Seckl MJ, Stebbing J, Sharma R, Mauri FA. Prognostic performance of inflammation-based prognostic indices in primary operable non-small cell lung cancer. Br J Cancer 2014; 110: 1930-1935.

Teramukai S, Kitano T, Kishida Y, Kawahara M, Kubota K, Komuta K, et al. Pretreatment neutrophil count as an independent prognostic factor in advanced non-small-cell lung cancer: an analysis of Japan Multinational Trial Organisation LC00-03. Eur J Cancer 2009; 45: 1950-1958.

Jafri SH, Shi R, Mills G. Advance lung cancer inflammation index (ALI) at diagnosis is a prognostic marker in patients with metastatic non-small cell lung cancer (NSCLC): a retrospective review. BMC Cancer 2013; 13: 158.

Lee Y, Kim SH, Han JY, Kim HT, Yun T, Lee JS. Early neutrophil-to-lymphocyte ratio reduction as a surrogate marker of prognosis in never smokers with advanced lung adenocarcinoma receiving gefitinib or standard chemotherapy as first-line therapy. J Cancer Res Clin Oncol 2012; 138: 2009-2016.

Wu G, Yao Y, Bai C, Zeng J, Shi D, Gu X, et al. Combination of platelet to lymphocyte ratio and neutrophil to lymphocyte ratio is a useful prognostic factor in advanced non-small cell lung cancer patients. Thorac Cancer 2015; 6: 275-287.

Gonzalez-Fajardo JA, Brizuela-Sanz JA, Aguirre-Gervas B, Merino-Diaz B, Del Rio-Sola L, Martin-Pedrosa M, et al. Prognostic significance of an elevated neutrophil-lymphocyte ratio in the amputation-free survival of patients withchronic critical limb ischemia. Ann Vasc Surg 2014; 28: 999-1004.

Tasoglu I, Cicek OF, Lafci G, Kadirogullari E, Sert DE, Demir A, et al. Usefulness of neutrophil/lymphocyte ratio as a predictor of amputation after embolectomy for acute limb ischemia. Ann Vasc Surg 2014; 28: 606-613.

Luo H, Yuan D, Yang H, Yukui M, Huang B, Yang Y, et al. Post-treatment neutrophil-lymphocyte ratio independently predicts amputation in critical limb ischemia without operation. Clinics 2015; 70: 273-277.

Zheng LQ, Yu JM, Li J, Sun ZQ, Sun YX, Hu DY. Mean level of ankle-brachial index and prevalence of peripheral arterial disease among inpatients with equal-risk to coronary heart disease. Chin J Arterioscler 2007; 15: 857-860.


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