Neutrophil-to-lymphocyte Ratio Associated with an Increased Risk of Mortality in Patients with Critical Limb Ischemia

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2021 May 27

PMID 34043672

Citations 4

Authors

Min-I Su

Cheng-Wei Liu

Affiliations

Soon will be listed here.

Abstract

Purpose: Association of the neutrophil-to-lymphocyte ratio (NLR) with mortality has not been comprehensively explored in critical limb ischemia (CLI) patients. We investigated the association between the NLR and clinical outcomes in CLI.

Materials And Methods: We retrospectively enrolled consecutive CLI patients between 1/1/2013 and 12/31/2018. Receiver operating characteristic curve analysis determined NLR cutoffs for 1-year in-hospital, all-cause and cardiac-related mortality; major adverse cardiovascular events (MACEs); and major adverse limb events (MALEs).

Results: Among 195 patients (age, 74.0 years, SD: 11.5; 51.8% male; body mass index, 23.4 kg/m2, SD: 4.2), 14.4% exhibited acute limb ischemia. After 1 year, patients with NLR>8 had higher in-hospital mortality (21.1% vs. 3.6%, P<0.001), all-cause mortality (54.4% vs. 13.8%, P<0.001), cardiac-related mortality (28.1% vs. 6.5%, P<0.001), MACE (29.8% vs. 13.0%, P = 0.008), and MALE (28.1% vs. 13.0%, P = 0.021) rates than those with NLR<8. In multivariate logistic regression, NLR≥8 was significantly associated with all-cause (P<0.001) and cardiac-related (adjusted HR: 5.286, 95% CI: 2.075-13.47, P<0.001) mortality, and NLR≥6 was significantly associated with MALEs (adjusted HR: 2.804, 95% CI: 1.292-6.088, P = 0.009). Each increase in the NLR was associated with increases in all-cause (adjusted HR: 1.028, 95% CI: 1.008-1.049, P = 0.007) and cardiac-related (adjusted HR:1.027, 95% CI: 0.998-1.057, P = 0.073) mortality but not in-hospital mortality or MACEs.

Conclusion: CLI patients with high NLRs had significantly higher risks of 1-year all-cause and cardiac-related mortality and MALEs. The NLR can be used for prognostic prediction in these patients.

Citing Articles

Neutrophil-to-lymphocyte ratio as a prognostic biomarker in patients with peripheral artery disease: A systematic review and meta-analysis.

Kurniawan R, Siahaan P, Saputra P, Arnindita J, Savitri C, Faizah N Vasc Med. 2024; 29(6):687-699.

PMID: 39415502 PMC: 11590382. DOI: 10.1177/1358863X241281699.

Narrative Review of Biological Markers in Chronic Limb-Threatening Ischemia.

Popescu A, Rata A, Barac S, Popescu R, Onofrei R, Vlad C Biomedicines. 2024; 12(4).

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The Role of Neutrophils in Lower Limb Peripheral Artery Disease: State of the Art and Future Perspectives.

Buso G, Faggin E, Rosenblatt-Velin N, Pellegrin M, Galliazzo S, Calanca L Int J Mol Sci. 2023; 24(2).

PMID: 36674682 PMC: 9866688. DOI: 10.3390/ijms24021169.

Endovascular interventions may save limbs in elderly subjects with severe lower extremity arterial disease.

Su M, Liu C J Geriatr Cardiol. 2021; 18(11):957-967.

PMID: 34908930 PMC: 8648539. DOI: 10.11909/j.issn.1671-5411.2021.11.007.

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