The benefit of dynamic neutrophil-lymphocyte ratio and systemic immune-inflammation index in predicting survival in patients undergoing hemiarthroplasty

M.M. Bala

Department of Orthopedics and Traumatology, Health Sciences University, Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey. muratbala@hotmail.com

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• Orthopedics
• Traumatology

OBJECTIVE: We aimed at investigating the relationship between the values of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII) in the preoperative and postoperative periods in patients who underwent hemiarthroplasty.

PATIENTS AND METHODS: The medical records of patients aged >65 years who underwent hemiarthroplasty due to hip fracture in our institution between January 2017 and December 2020 were examined. Dynamic Neutrophil-to-lymphocyte ratio (dNLR), platelet-to-lymphocyte ratio (dPLR), and systemic immune-inflammation index (dSII) were calculated using biomarker data (neutrophil, lymphocyte, and platelet counts) obtained at admission and on postoperative day 2 and 5.

RESULTS: A total of 176 individuals (119 females, 57 males) were included in the study. The PLR on postoperative day 2, and NLR and SII measurement on postoperative day 2 and 5 in patients were found to have significant predictive value in 1-year mortality rates. A 1-year increase in age was associated with a 4.9% increased risk of death at 1-year follow-up (p=0.006). A 1-unit increase in NLR on postoperative day 5 was associated with a 4.3% increased risk of death at 1-year follow-up (p=0.004).

CONCLUSIONS: The present study shows that our model for predicting the absolute mortality risk in patients can be improved by evaluating dSII, dPLR, and dNLR in the preoperative period and postoperative day 2 and 5. However, it cannot be said that the model has a discriminatory ability to exactly predict postoperative mortality. Nevertheless, these parameters may aid in the development of early therapeutic intervention to improve patient outcomes.

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