Predictive value of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio for acute deep vein thrombosis after
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RESEARCH ARTICLE
Open Access
Predictive value of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio for acute deep vein thrombosis after total joint arthroplasty: a retrospective study Chen Yao1,2†, Zhe Zhang1,2†, Yao Yao1,2, Xingquan Xu1,2, Qing Jiang1,2* and Dongquan Shi1,2*
Abstract Background: Deep vein thrombosis (DVT) is a common and severe complication of total joint arthroplasty (TJA). Inflammation has been proved to play a role in DVT. The neutrophil to lymphocyte ratio (NLR) and the platelet to lymphocyte ratio (PLR) are biomarkers for systemic inflammation. The aim of the study is to investigate the predictive value of NLR and PLR for acute TJA-induced DVT. Method: A total of 773 patients who underwent primary TJA in our hospital were included in this retrospective study. Venography was performed routinely after the surgery to define acute DVT. NLR and PLR before and after operation were calculated according to the blood routine test. Multiple logistic regression analyses and ROC curve analyses were performed to assess the association of NLR and PLR with TJA-induced DVT. Results: One hundred twenty out of 773 patients (15.5%) were diagnosed with DVT by venography. In patients with DVT, preoperative NLR (P = 0.030) and postoperative NLR (P = 0.015) were significantly higher but postoperative PLR (P = 0.002) was significantly lower. Multiple logistic regression analyses indicated that age (OR = 1.05, P < 0.005), gender (OR = 0.47, P = 0.005), BMI (OR = 1.06, P < 0.014), preoperative NLR (OR = 1.11, P < 0.035), postoperative NLR (OR = 1.20, P < 0.001), and PLR (OR = 0.99, P < 0.001) were independently associated with DVT. However, the ROC curve analysis demonstrated the specificity and sensitivity of NLR or PLR in predicting DVT were low. Conclusion: Although the present study demonstrated significant association of perioperative NLR or PLR with acute TJA-induced DVT, NLR or PLR cannot predict TJA-induced DVT accurately. Keywords: Neutrophil to lymphocyte ratio, Platelet to lymphocyte ratio, Deep vein thrombosis, Total joint arthroplasty
Background Total joint arthroplasty (TJA), including total knee arthroplasty (TKA) and total hip arhroplasty (THA), has been performed widely for end-stage diseases of the knee and hip. Deep vein thrombosis (DVT) is a common and severe complication of TJA, especially in hospitalized patients [1, 2]. DVT can lead to pulmonary embolism * Correspondence: [email protected]; [email protected] † Equal contributors 1 Department of Sports Medicine and Adult Reconstructive Surgery, Nanjing Drum Tower Hospital affiliated with the Medical School of Nanjing University, Nanjing, Jiangsu, China Full list of author information is available at the end of the article
(PE), which may occur rapidly and cause immediate death. Although the mechanical and pharmacological prophylaxis significantly reduced the incidence of postsurgical DVT, it remains a major cause of postoperative morbidity and mortality [3]. Lack of subject symptoms and clinical signs make diagnosis of DVT
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