High platelet-to-lymphocyte ratio predicts poor survival of elderly patients with hip fracture
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ORIGINAL PAPER
High platelet-to-lymphocyte ratio predicts poor survival of elderly patients with hip fracture Zhicong Wang 1 & Hong Wang 1 & Ling Yang 1 & Wei Jiang 1 & Xi Chen 1 & Yuehong Liu 1 Received: 10 July 2020 / Accepted: 23 September 2020 # SICOT aisbl 2020
Abstract Purpose The platelet-to-lymphocyte ratio (PLR) has been extensively studied in various diseases. However, the relationship between PLR and hip fracture remains unknown. The aim of this study was to evaluate whether PLR would be an independent prognostic factor in elderly hip fracture patients. Methods Between January 2014 and December 2018, a retrospective cohort study was conducted in a orthopaedic centre, China. A total of 460 hip fracture patients were included. PLR was calculated as the ratio of platelet to lymphocyte counts and divided into high PLR group (≥ 189) and low PLR group (< 189) by using the receiver operating characteristic (ROC) curve. The relationship between PLR and one year all-cause mortality rate was assessed by univariate and multivariate Cox proportional hazard models. Further subgroup analysis stratified by different clinical and biological characteristics was performed to make the results more accurate. Results After a median follow-up of 32.0 months (range, 12.0–75.4), 92 patients (mortality rate: 20.0%) died within one year. PLR was significantly higher in dead patients compared with alive patients (p < 0.05), and high PLR group also had a high mortality rate (32.21% vs. 14.15%, p < 0.001). After multivariate adjustment, high PLR remained an independent predictor for one year all-cause mortality (adjusted hazard ratio (HR) 1.56, 95% confidence interval (CI) 1.02–2.41, p = 0.041). Moreover, advanced age (HR 1.05, 95% CI 1.01–1.08), male (HR 1.62, 95% CI 1.06–2.45), CCI ≥ 2 (HR 2.83, 95% CI 1.64–4.89), conservative treatment (HR 5.94, 95% CI 3.71–9.73), low haemoglobin level (HR 1.02, 95% CI 1.01–1.04), and low albumin level (HR 1.07, 95% CI 1.02–1.13) were independent risk factors for survival. Furthermore, subgroup analysis results were consistent with the main findings in most stratified groups. Conclusion This study highlights that high PLR (≥ 189) is associated with increased one year all-cause mortality in elderly hip fracture patients. As PLR is a simple indicator that can be calculated from the blood routine test, it can be easily performed in usual clinical practice. Keywords Elderly . Hip fracture . Platelet-to-lymphocyte ratio . Prognosis . Mortality
Introduction Due to the high morbidity and mortality, hip fracture has become a major public health issue worldwide. A recent meta-analysis
showed that the one year mortality rate was 13.96% after hip fracture in mainland China [1], and hip fracture was associated with excess short- and long-term all-cause mortality in Europe and USA [2]. At the same time, hip fracture incidence data
Zhicong Wang and Hong Wang contributed equally to this work. * Yuehong Liu [email protected]
Wei Jiang [email protected]
Zhicong Wang [email protected] Hong W
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