PMID- 33496158
OWN - NLM
STAT- MEDLINE
DCOM- 20210917
LR  - 20210917
IS  - 1827-1839 (Electronic)
IS  - 0392-9590 (Linking)
VI  - 40
IP  - 2
DP  - 2021 Apr
TI  - Neutrophil-lymphocyte ratio as a link between complex pedal ulcers and poor 
      clinical results after infrainguinal surgical revascularization.
PG  - 112-124
LID - 10.23736/S0392-9590.21.04582-X [doi]
AB  - BACKGROUND: Our aim was to evaluate the influence of preoperative 
      neutrophil-lymphocyte ratio (NLR) on patency and clinical results after 
      infrainguinal surgical revascularization for chronic limb ischemia. METHODS: 
      Retrospective analysis of 150 infrainguinal autologous bypasses performed to 
      infragenicular popliteal artery or tibial vessels in 140 (93%) patients with 
      chronic limb-threatening ischemia (CLTI) and in 10 (7%) with disabling 
      claudication. NLR was calculated using blood samples obtained 24 hours 
      preoperatively. The cohort was stratified into 2 groups according to 
      interquartile ranges of NLR: "ELEVATED-NLR" (Quartile 4 N.=37) and "LOW-NLR" 
      (Quartile 1-2-3 N.=113). Reperfused ulcers were described using the WIfI 
      classification. Patency, freedom from MALE and amputation-free survival at 24 
      months were calculated using the Kaplan-Meier method. Univariate comparisons 
      between NLR groups were performed using the Log-Rank test. Statistical 
      differences on univariate analysis were adjusted in a multivariate model (Cox 
      regression). RESULTS: NLR values were similar between CLTI and claudication. 
      Ischemic ulcers were more frequent, (83.4% vs. 59.3% P<0.01), more severe (W2-3: 
      37.8% vs. 22.1% P=0.01) and pedal infection was deeper (fI 2-3: 40.5% vs. 18.6% 
      P=0.003) in "ELEVATED-NLR" group. Severe ischemia (I3) was similar between 
      groups. High NLR values were independent predictors of patency loss (HR: 1.77 
      CI95% [1.01-3.10] P=0.04), MALE (HR: 2.04 CI95% [1.03-4.04] P=0.04) and worse 
      amputation-free survival (HR:2.10 CI95% [1.06-4.14] P=0.03) rates at 24 months. 
      CONCLUSIONS: High preoperative NLR values are associated with severe and deep 
      infected ulcers and predicts primary patency loss, higher major adverse limb 
      events and worse amputation-free survival rates on long-term follow-up after 
      infrainguinal surgical revascularization.
FAU - GonzAlez-Hernandez, Julio
AU  - GonzAlez-Hernandez J
AD  - Department of Angiology and Vascular-Endovascular Surgery, University Hospital of 
      Getafe, Getafe, Spain.
FAU - Varela, Cesar
AU  - Varela C
AD  - Department of Angiology and Vascular-Endovascular Surgery, University Hospital of 
      Getafe, Getafe, Spain - cvarelacasariego@gmail.com.
FAU - Michel, Ignacio
AU  - Michel I
AD  - Department of Angiology and Vascular-Endovascular Surgery, University Hospital of 
      Getafe, Getafe, Spain.
FAU - Laime, Ilsem V
AU  - Laime IV
AD  - Department of Angiology and Vascular-Endovascular Surgery, University Hospital of 
      Getafe, Getafe, Spain.
FAU - Uyaguari, Jhenifer
AU  - Uyaguari J
AD  - Department of Angiology and Vascular-Endovascular Surgery, University Hospital of 
      Getafe, Getafe, Spain.
FAU - March, Jose R
AU  - March JR
AD  - Department of Angiology and Vascular-Endovascular Surgery, University Hospital of 
      Getafe, Getafe, Spain.
LA  - eng
PT  - Journal Article
DEP - 20210126
PL  - Italy
TA  - Int Angiol
JT  - International angiology : a journal of the International Union of Angiology
JID - 8402693
SB  - IM
MH  - Humans
MH  - Limb Salvage
MH  - Lymphocytes
MH  - *Neutrophils
MH  - *Peripheral Arterial Disease/diagnosis/surgery
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Treatment Outcome
MH  - Ulcer
EDAT- 2021/01/27 06:00
MHDA- 2021/09/18 06:00
CRDT- 2021/01/26 06:08
PHST- 2021/01/27 06:00 [pubmed]
PHST- 2021/09/18 06:00 [medline]
PHST- 2021/01/26 06:08 [entrez]
AID - S0392-9590.21.04582-X [pii]
AID - 10.23736/S0392-9590.21.04582-X [doi]
PST - ppublish
SO  - Int Angiol. 2021 Apr;40(2):112-124. doi: 10.23736/S0392-9590.21.04582-X. Epub 
      2021 Jan 26.