Can Ratio of Neutrophil-to-Lymphocyte Count and Erythrocyte Sedimentation Rate in Diabetic Foot Infecti on Predict Osteomyelitis and/or Amputation?

Oktay Yapıcı,Hande Berk,Alper Tahmaz,Derya Seyman,Alparslan Merdin,Nefise Öztoprak

doi:10.4081/hr.2017.6981

Abstract

The aim of this study was to search for any relations between the neutrophil-to-lymphocyte ratio (NLR) and the development of osteomyelitis and the need for amputation in patients with diabetic foot infection (DFI). All data included DFI patients who were hospitalized in our Infectious Diseases Clinic between 2012 and 2015 and who were classified according to International Classification Disease Code System. 75 patients were analyzed in the study. The DFI patients were stratified into 3 groups of whom had amputation procedure, whom had only debridement/drainage procedure and whom had any surgery procedure. Sidac post hoc analysis was used to perform the effects of NLR, C-reactive protein, erythrocyte sedimentation rate and glycosylated hemoglobin on the surgery procedure status. The DFI patients were also stratified into two another separate group for another analysis to search for the effect of NLR values on the development of osteomyelitis. The mean value of NLR in the amputated patients’ group (15.7±10.3 was significantly higher than those with debridement procedure (9.9±5.6) and those without any surgery (6.0±2.8) (P=0.001). NLR values were also found significantly higher in patients with osteomyelitis in the second analysis (P=0.004). In this study, the NLR was found to have a predictive value on the development of osteomyelitis and on the progression to amputation in patients with DFI.

Highlights

ResultsThe initial neutrophil-ton lymphocyte ratio (NLR) and ESR values were found significantly higher in patients withIrritation, inflammation, ischemia, neu-A total of 75 patients [males: 54 (72%) osteomyelitis (P=0.004, P=0.001, respectiropathy and infections are important factors females: 21 (28%)] were included in the vely) (Table 2).in diabetic foot pathophysiology.[1,2] Studies study
All data included diabetic foot e infection (DFI) patients who were hospitalized in our Infectious Diseases Clinic between 2012 and 2015 and who were classified according to International Classification Disease (ICD-10) Code System. 25 patients whom had amputation procedure, 25 patients whom had only debridement/drainage procedure, and 25 patients whom had any surgery procedure were included in the study
Physical examination and/or laboratory methods were used to put the diagnosis of DFI

Summary

Introduction

ResultsThe initial NLR and ESR values were found significantly higher in patients withIrritation, inflammation, ischemia, neu-A total of 75 patients [males: 54 (72%) osteomyelitis (P=0.004, P=0.001, respectiropathy and infections are important factors females: 21 (28%)] were included in the vely) (Table 2).in diabetic foot pathophysiology.[1,2] Studies study. The initial NLR and ESR values were found significantly higher in patients with. A total of 75 patients [males: 54 (72%) osteomyelitis (P=0.004, P=0.001, respectiropathy and infections are important factors females: 21 (28%)] were included in the vely) (Table 2). In diabetic foot pathophysiology.[1,2] Studies study. Seventy two percent of the patients [Hematology Reports 2017; 9:6981] [page 19] Article Mean values

Objectives

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Methods