Neutrophil-lymphocyte ratio predicts disease severity and outcome after lower extremity procedures

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

“…The NLR value increased with higher Rutherford stages in the present study, consistent with a previous study by Bath et al 19 Another study also showed that disease severity and the values of high-sensitivity C-reactive protein signi cantly increased across tertiles of NLR in patients with lower limb arteriosclerosis obliterans 20 . NLR, as a biomarker of the in ammatory response and disease severity, has been proposed to contribute to mortality in CLI patients, but NLR as a continuous variable was not associated with MALE in the present study.…”

“…In the study by Erturk et al 13 , the NLR cut-off was even lower, at three, because more than sixty percent of the patients were at Rutherford stages III and IV. The major differences between our and other studies are related to the study populations; compared to previous investigators who enrolled patients with peripheral artery diseases and weaker in ammatory responses, we enrolled CLI patients with stronger in ammatory responses 13,19 . In other words, the neutrophil ratio in our patients indicates a stronger in ammatory response, whereas patients in the other study had weaker in ammation 12 .…”

“…A strength of our study is that we report comprehensive outcomes, including MACE. All-cause mortality has been reported in many studies 12,17−20 , cardiac morality in only a few studies 12,18 , and amputation in only a few studies 12,17,19,20 ; however, no study has previously reported MACE and MALE in patients with CLI or stable LEAD with regard for the NLR. The best cut-off for NLR, as determined by receiver operating characteristic curves, was eight in the present study, but this cut-off for NLR is not consistent with previous studies, in which it has also not been universal and ranges from three to ve 12,13,17−20 .…”

“…In other words, the neutrophil ratio in our patients indicates a stronger in ammatory response, whereas patients in the other study had weaker in ammation 12 . In studies that enrolled patients with either CLI or stable LEAD 19 , the cut-off for NLR may be reduced by the patients with stable LEAD, and the resulting lower NLR threshold may be unable to adequately stratify CLI patients with higher cardiovascular risks. We conducted the present study by enrolling only CLI patients while excluding patients with stable LEAD to make our study population homogeneous, and we therefore suggest that an NLR cut-off of eight could be used in CLI patients to evaluate the risk of all-cause mortality in future studies.…”

Prognostic role of neutrophil-to-lymphocyte ratio in aortic disease: a meta-analysis of observational studies

“…They found that raised NLR appeared to be associated with increased mortality and morbidity after cardiac and vascular surgery [10]. Elevated NLR was also associated with increasingly severe symptoms of peripheral artery disease in a graded response from claudication to tissue loss, and was independently associated with preoperatively and postoperatively and complications after lower extremity procedures [41].…”