PDF(Pubmed)
Abstract：
Introduction Diabetic foot infection is a condition that affects the patient\'s life, may cause limb loss, and has a high mortality. Too many parameters were used for predicting early mortality but the gold standard method wasn\'t described. Neutrophil lymphocyte ratio (NLR) is universally accepted as a predictive value for amputation-free survival and mortality. NLR increases due to inflammation-induced neutrophilia and lymphopenia related to cortisol-induced stress. Increasing in the neutrophil albumin ratio is expected due to decreasing albumin levels because albumin is a negative acute-phase reactant. The aim of this study is to investigate the sensitivity and value of the neutrophil albumin ratio (NAR) for early mortality after major lower extremity amputation (LEA). Methods Following the approval of the ethics committee, 87 patients who underwent major LEA between May 2018 and May 2020 were analyzed for the study. White blood cell (WBC), neutrophil, lymphocyte, C-reactive protein (CRP), creatinine, albumin, platelet, and hemoglobin values on the day prior to surgery were recorded. NLR was calculated as the ratio of neutrophil count to lymphocyte count, NAR as the ratio of neutrophil count to albumin value, CRP/albumin ratio (CAR) as the ratio of CRP value to albumin value, and platelet lymphocyte ratio (PLR) as the ratio of platelet count to lymphocyte count. Each parameter was also recorded in the postoperative second week. Results Of the patients included in the study, 52 were men (59.8%) and 35 were women (40.2%). It was determined that 29 of 87 patients (33.3%) died within the first year. The relationship between post-operative NAR value and early mortality is examined. The area under the curve was calculated as 0.873. When the cut-off value was applied as 0.265, the sensitivity was found as 88% and specificity as 76%. Conclusions Higher neutrophil/albumin ratio after lower extremity amputation was associated with early mortality after extremity amputation. This parameter can help predict mortality. The cut-off value was determined as 0.265, the sensitivity was found as 88%, and specificity as 76%.
摘要：
介绍糖尿病足感染是一种影响患者生命的疾病,可能会导致肢体丧失,而且死亡率很高.使用了太多参数来预测早期死亡率，但没有描述黄金标准方法。中性粒细胞淋巴细胞比率（NLR）被公认为无截肢生存率和死亡率的预测价值。NLR由于炎症诱导的嗜中性粒细胞增多和与皮质醇诱导的应激相关的淋巴细胞减少而增加。由于白蛋白是负急性期反应物，因此预期中性粒细胞白蛋白比率会增加，因为白蛋白水平会降低。这项研究的目的是探讨中性粒细胞白蛋白比率（NAR）对下肢严重截肢（LEA）后早期死亡率的敏感性和价值。方法伦理委员会批准后，对2018年5月至2020年5月期间接受主要LEA的87例患者进行了分析。白细胞（WBC），中性粒细胞,淋巴细胞，C反应蛋白(CRP),肌酐,白蛋白,血小板,记录手术前一天的血红蛋白值.NLR计算为中性粒细胞计数与淋巴细胞计数之比，NAR为中性粒细胞计数与白蛋白值之比，CRP/白蛋白比值(CAR)为CRP值与白蛋白值之比,血小板淋巴细胞比值(PLR)为血小板计数与淋巴细胞计数的比值。在术后第二周也记录每个参数。结果纳入研究的患者中，男性52人（59.8%），女性35人（40.2%）。确定87名患者中有29名（33.3％）在第一年内死亡。检查了术后NAR值与早期死亡率之间的关系。曲线下面积计算为0.873。当截止值应用为0.265时,发现灵敏度为88%,特异性为76%。结论下肢截肢术后中性粒细胞/白蛋白比值升高与截肢术后早期死亡率相关。这个参数可以帮助预测死亡率。截止值被确定为0.265，灵敏度被发现为88%，特异性为76%。
