Neutrophil/lymphocyte and platelet/lymphocyte ratios as a biomarker in postoperative wound infections

Abstract

Objectives We aimed to investigate retrospectively the association between the development of surgical wound infection after orthopedic surgery, and neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) obtained from complete blood count results. Methods A total of 120 patients who underwent orthopedic surgery between 2018 and 2020 were evaluated retrospectively in our study. Wound culture results, complete blood counts, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) values, orthopedic surgery, and wound types were obtained from the laboratory data administration system. The data were statistically analyzed using SPSS 22.0 software. Results A total of 70 patients who experienced surgical wound infection (66% males and 34% females) and 50 patients without wound infection (64% males and 36% females) were included in this study. The mean age was 46.8 +/- 11.4 years for the patients with infection after surgery and 50.1 +/- 11.7 years for the patients without infection. Preoperative CRP, NLR, and PLR, and post-operative white blood cell (WBC), neutrophils, ESR, CRP, NLR, and PLR values were significantly higher, and lymphocyte concentrations were significantly lower in the group with infection, in comparison with those without infection. In the postoperative period, CRP and ESR were high in patients with and without infection, while NLR was increased in only those with infection. A medium-level correlation was found between NLR and PLR, and CRP and ESR. Sensitivity was 66%, and specificity was 68% with a cut-off of >3.5 for NLR, while sensitivity was 42% and specificity was 71% with a cut-off of >135 for PLR. Conclusions We believe that the estimation of NLR and PLR values before the intervention in patients undergoing orthopedic surgery may be advantageous for identifying infection.