The neutrophil-to-lymphocyte ratio (NLR) after surgery for hip fracture (HF)

Forget, Patrice;Moreau, Nicolas;Engel, Harald;Cornu, Olivier;Yombi, Jean Cyr;et.al.
(2015) Archives of Gerontology and Geriatrics — Vol. 60, n° 2, p. 366-371 (2015)

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Abstract
Background: The NLR is a prognostic factor for outcome and survival in cardiology, oncology and digestive surgery. NLR has not yet been studied in HF. Methods: Retrospective analysis of a prospective cohort of 247 consecutive patients, older than 65. years, operated for HF. Mortality at 12. months was registered, as the perioperative NLR values. Results: After hip surgery in the 247 patients (women 71%, median age 85 years, range: 66-102), the mortality was 27.2% [95%confidence interval (CI): 21.4-33.0] at 12. months. Univariate analysis detected four risk factors for mortality: age (Hazard Ratio (HR) - by 10. year-increments: 2.08 [95%CI: 1.37-3.17], P<. 0.001), male gender (HR: 1.92 [95%CI: 1.17-3.14], P=. 0.009, MCM (≥3) (HR: 1.71 [95%CI: 1.006-2.92], P=. 0.047 and NLR > 5 at day 5 (HR: 1.8 [95%CI: 1.11-2.94], P=. 0.002). In multivariate analysis, two factors remained significantly associated with mortality: age (HR: 2.28 [95%CI: 1.49-3.47], P<. 0.001) and male gender (HR: 2.26 [95%CI: 1.38-3.72], P=. 0.001). Two independent risk factors of postoperative cardiovascular complications were identified: NLR > 5 at day 5 (Odds Ratio (OR): 3.34 [95%CI: 2.33-4.80], P=. 0.001) and MCM (OR: 3.04 [95%CI: 2.16-4.29], P=. 0.006). A higher risk of infection was independently associated with a NLR > 5 at day 5 (OR: 2.12 [95%CI: 1.44-3.11], P=. 0.02). Conclusions: The NLR at fifth postoperative day is a risk factor of postoperative mortality and cardiovascular complications.
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Forget, P., Moreau, N., Engel, H., Cornu, O., Boland, B., De Kock, M., & Yombi, J. C. (2015). The neutrophil-to-lymphocyte ratio (NLR) after surgery for hip fracture (HF). Archives of Gerontology and Geriatrics, 60(2), 366-371. https://doi.org/10.1016/j.archger.2014.11.008 (Original work published 2015)