Key result
Elevated day 5 neutrophil-lymphocyte ratio strongly predicts mortality in elderly hip fracture patients.
Why the study?
The study aimed to examine the effect of neutrophil-lymphocyte ratio on mortality and morbidity in patients over the age of 65 operated on due to hip fracture.
Does an increased neutrophil-lymphocyte ratio predict mortality and morbidity in elderly patients operated on for hip fracture?
Cohort (n=132)
No
Does an increased neutrophil-lymphocyte ratio predict mortality and morbidity in elderly patients operated on for hip fracture?
Effect estimate: AUC 0.953 (95% CI 0.908-0.999)
p-value: p=0.007
An increased neutrophil-lymphocyte ratio on the 5th postoperative day is associated with higher mortality and ICU admission rates in elderly patients following hip fracture surgery.
Elevated day-5 NLR was associated with ICU admission and mortality after hip fracture surgery; hypothesis-generating for risk stratification, prospective validation needed.
Introduction In this study, we aimed to examine the effect of neutrophil-lymphocyte ratio (NLR) on mortality and morbidity in elderly patients over the age of 65 who presented to our clinic and were operated on due to hip fracture. Methods The study included patients over the age of 65 who were operated on in our hospital between January 2014 and December 2018 due to hip fracture. Those with multiple fractures and those who were operated on due to cancer-related fracture were excluded. Patients' age, gender, American Society of Anesthesiologists (ASA) score, preoperative waiting time, type of anesthesia, operation duration, amount of erythrocyte suspension used, and duration of intensive care unit (ICU) stay were recorded. The effect of increased preoperative and postoperative 5th day neutrophil-lymphocyte ratios (NLR 1 and NLR 5, respectively) on mortality and morbidity was investigated. Results We examined 132 patients operated on due to hip fracture. NLR 5 was higher among patients who were admitted to the ICU (p = 0.007) and among those who died (p = 0.007). Additionally, the rate of increase of NLR 5 was higher among patients who were admitted to the ICU (p = 0.044) and among those died (p = 0.009). Conclusion The rate of increase of NLR in the postoperative period can be used as a criterion for predicting mortality in patients who are operated on due to hip fracture.
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Atlas et al. (2020) conducted a cohort in Hip fracture (n=132). Increased postoperative neutrophil-lymphocyte ratio vs. Lower postoperative neutrophil-lymphocyte ratio was evaluated on Mortality prediction by postoperative 5th day neutrophil-lymphocyte ratio (AUC 0.953, 95% CI 0.908-0.999, p=0.007). An increased neutrophil-lymphocyte ratio on the 5th postoperative day strongly predicted mortality in elderly patients operated on for hip fracture (AUC 0.953, p=0.007).
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