Predictive value of neutrophil-to-lymphocyte ratio in diabetic wound healing

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.

Conflict of interest statement

Author conflict of interest: none.

Copyright © 2016 Society for Vascular Surgery. All rights reserved.

Figures

Fig 1

A comparison of mean neutrophil-to-lymphocyte ratio (NLR) in different wound outcome groups; the P value shows the result of W test.

Fig 2

Wound outcomes by tertiles of neutrophil-to-lymphocyte ratio (NLR).

Fig 3

Receiver operating characteristic (ROC) curve showing the optimum cutoff value of neutrophil-to-lymphocyte ratio (NLR) to predict wound healing in diabetic foot ulcer.