Platelet-hemoglobin ratio predicts amputation in patients with below-knee peripheral arterial disease

Abstract

Background Peripheral arterial disease (PAD) causes significant morbidity today. Atherosclerosis is evident in the pathophysiological process in most patients, so PAD has similar risk factors as coronary artery disease. Platelet-Hemoglobin ratio (PHR) has been proven to predict mortality in atherosclerotic heart disease. We aimed to determine the relationship between PHR and below-knee amputation. Methods The study is a single-center retrospective study. Platelet count/hemoglobin amount formula was used for PHR. Only PAD patients with below-knee critical extremity ischemia and unsuitable for revascularization were included in the study. Results 235 patients were included in the study retrospectively. The mean age was 65.7 ± 9.9 years and 175(74.5%) of them were male. In the amputated group, white blood cell, neutrophil, platelet, creatinine, glucose, and PHR were higher (p = .031, p = .045, p = .011, p = .048 p = .018, p = .004, respectively). Only hemoglobin values were lower (p = .003). Multivariable regression analysis showed; age, albumin and PHR were determined as independent risk factors for amputation (Age; OR (95%CI): (1.094(1.040–1.152), p = .001) (Albumin; OR (95% CI): 1.950(1.623–1.799), p = .001) (PHR; OR (95% CI): 1.872(1.246–2.812), p = .003). Receiver operating characteristics analysis performed to determine the optimal cut-off value of PHR for amputation, the optimal value was found 2.08 (65.8% sensitivity, 67.5% specificity, p < .001). Conclusions PHR was a good predictor for BKA. Using the PHR, it may be possible to identify high-risk patients for amputation.

Association of inflammation indices with left atrial thrombus in patients with valvular atrial fibrillation

“…Another promising pharmacological agent, sodium-glucose cotransporter 2 inhibitor, could also decrease the level of NLR by directly targeting inflammatory pathways such as nucleotide-binding domain-like receptor protein-3 inflammasome [ 21 , 22 ]. Recent evidence suggested that inflammation indices could identify high-risk patients with thromboembolic diseases such as acute pulmonary embolism or peripheral arterial disease [ 23 , 24 ]. Therefore, based on our study and findings from previous investigations, systemic inflammation might underlie the association between the indices examined in our study and LAT in VAF patients.…”

Predictive value of systemic immune inflammation index (SII) and prognostic nutritional index (PNI) on mortality after below-knee amputation

“…[1][2][3] Although there are important developments in the field of below-knee operations in terms of materials and methods, mortality after below-knee operations remains an important problem today. [19][20][21][22][23] The scarcity of studies on mortality and quality of life of patients after below-knee operations indicates that further clinical studies are needed on this subject. However, after the below-knee, changes occur not only in the daily lives of patients but also in their economic and social lives.…”

A practical nomogram for predicting amputation rates in acute compartment syndrome patients based on clinical factors and biochemical blood markers

“…Our study’s results support this caution and suggest that continuous physical examination, active pressure monitoring, and timely fasciotomy compression, along with vascular damage and antishock management, can help reduce the incidence of amputation in patients with vascular damage. In addition, previous studies have found that low albumin levels are an independent risk factor for amputation in patients with peripheral arterial disease [ 33 ]. This is consistent with our findings.…”

“…This is consistent with our findings. Low albumin levels and malnutrition can lead to increased systemic inflammation and vascular sclerosis, and proper dietary supplementation can effectively prevent disease progression and worse outcomes [ 33 – 35 ]. Additionally, one study found that CPK levels were significantly higher in patients with confirmed compartment syndrome compared to those without the condition [ 36 ].…”