Neutrophil–Lymphocyte Ratio as a Predictor of Venous Thromboembolism after Total Knee Replacement
| Autor: | Won-Woo Seo, Dong-Jin Oh, Kyoo-Rok Han, Jun-Hee Lee, Dae-Gyun Park, Min-Su Hyon, Myung-Soo Park, Sung Eun Kim |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Neutrophils Deep vein Venography 030204 cardiovascular system & hematology Chemoprevention Leukocyte Count 03 medical and health sciences 0302 clinical medicine medicine Humans Orthopedics and Sports Medicine Lymphocytes cardiovascular diseases Enoxaparin Arthroplasty Replacement Knee Aged Retrospective Studies Venous Thrombosis medicine.diagnostic_test business.industry fungi Anticoagulants Retrospective cohort study Venous Thromboembolism Odds ratio Middle Aged Prognosis equipment and supplies medicine.disease Thrombosis Surgery Pulmonary embolism medicine.anatomical_structure Absolute neutrophil count Female Pulmonary Embolism business Complication Biomarkers 030217 neurology & neurosurgery |
| Zdroj: | The Journal of Knee Surgery. 34:171-177 |
| ISSN: | 1938-2480 1538-8506 |
| Popis: | Venous thromboembolism (VTE) is a potentially serious complication after total knee replacement (TKR), and recent guideline recommends thromboprophylaxis for VTE after TKR. The neutrophil–lymphocyte ratio (NLR) has emerged as a simple and new prognostic biomarker for several cardiovascular diseases. This study was performed to investigate the precise incidence of postoperative VTE and the role of NLR for predicting VTE in patients receiving thromboprophylaxis after TKR. We retrospectively enrolled 264 patients undergoing TKR who underwent routine screening enhanced pulmonary artery and lower extremity venography computed tomography (CT) scan within 7 postoperative days. Biochemical tests were performed within 2 weeks prior to surgery, and the NLR was defined as the absolute neutrophil count in peripheral blood divided by lymphocyte count. All patients received thromboprophylaxis with enoxaparin postoperatively. Of 264 patients, 102 (38.6%) were diagnosed with deep vein thrombosis (DVT) or pulmonary embolism on CT scan. Preoperative NLR was significantly higher in patients with postoperative VTE compared with that in patients without VTE (2.57 ± 1.59 vs. 2.11 ± 1.10, p = 0.011). Receiver operating characteristic curve analysis showed that a preoperative NLR of 1.90 was the best cutoff value for the prediction of postoperative VTE (sensitivity 57.8%, specificity 55.6%, and area under curve 0.589). In the multivariate analysis, a preoperative NLR ≥1.90 was a sole independent predictor of postoperative VTE (odds ratio: 1.95, 95% computed tomography: 1.16–3.31, p = 0.013). The present study shows a higher incidence of VTE (38.6%) after TKR in patients receiving thromboprophylaxis than that reported in previous studies. Furthermore, preoperative NLR was significantly higher in patients with postoperative VTE, and a high preoperative NLR (≥1.90) was an independent predictor of VTE after TKR. NLR measurement may be a simple and useful method for the prediction of VTE in patients undergoing TKR. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|