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Predictive value of neutrophil-to-lymphocyte ratio in diabetic wound healing
Authors:Nasibeh Vatankhah  Younes Jahangiri  Gregory J. Landry  Robert B. McLafferty  Nabil J. Alkayed  Gregory L. Moneta  Amir F. Azarbal
Affiliation:1. Division of Vascular Surgery, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Ore;3. Department of Anesthesiology and Perioperative Medicine, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Ore;2. Dotter Interventional Institute, Oregon Health & Science University, Portland, Ore
Abstract:

Objective

The neutrophil-to-lymphocyte ratio (NLR) has been used as a surrogate marker of systemic inflammation. We sought to investigate the association between NLR and wound healing in diabetic wounds.

Methods

The outcomes of 120 diabetic foot ulcers in 101 patients referred from August 2011 to December 2014 were examined retrospectively. Demographic, patient-specific, and wound-specific variables as well as NLR at baseline visit were assessed. Outcomes were classified as ulcer healing, minor amputation, major amputation, and chronic ulcer.

Results

The subjects' mean age was 59.4 ± 13.0 years, and 67 (66%) were male. Final outcome was complete healing in 24 ulcers (20%), minor amputation in 58 (48%) and major amputation in 16 (13%), and 22 chronic ulcers (18%) at the last follow-up (median follow-up time, 6.8 months). In multivariate analysis, higher NLR (odds ratio, 13.61; P = .01) was associated with higher odds of nonhealing.

Conclusions

NLR can predict odds of complete healing in diabetic foot ulcers independent of wound infection and other factors.
Keywords:Correspondence: Nasibeh Vatankhah   MD   Division of Vascular Surgery   Knight Cardiovascular Institute   Oregon Health & Science University   3181 SW Sam Jackson Park Rd   OP-11   Portland   OR 97239
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