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Research Paper | Surgery | India | Volume 12 Issue 1, January 2023
Role of Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio in Diabetic Ulcer Patients
Dr. Tanveer Mohammed Zaid | Dr. Deepthi R [2] | Dr. Naman Maheshwari | Dr. Vinayaka S.
Abstract: Diabetic ulcers are a common occurrence in diabetic patients but remain a challenge with regard to scoring, prediction of outcome and planning of appropriate treatment plan. NLR is a novel perspective marker of cellular immune system activation, a valid index of stress and systemic inflammation. NLR is a cheap, simple, fast responding and easily available parameter of stress and inflammation with high sensitivity and low specificity. We sought to evaluate NLR and PLR in diabetic ulcers with association to patient and wound-specific factors that may help predict healing of diabetic ulcers. Aims: The association between Neutrophil-Lymphocyte ratio and Platelet-Lymphocyte ratio v/s wound healing in diabetic wounds. Study design: prospective observational study. Place and Duration of Study: Rajarajeswari Medical College, Bangalore; by the Department of General Surgery between 1st of January 2022 till 31st July 2022. Sample: all patients admitted and treated for diabetic ulcers. Methodology: 34 patients chosen in total. Demographic information, baseline wound characteristics, comorbidities, and laboratory data including NPR and PLR were correlated with ulcer healing and progression to healing ulcer or progressing ulcer (requiring further amputation) based on clinical description or daily notes. Results: A total of 34 patients were evaluated. Patients were an average age of 59.3 years. During the follow-up period, 32 ulcers (94.1%) healed and were discharged, while 2 patients died (5.9%).41.1% required amputations. On admission NLR (mean 13.8), PLR (mean 305.9) and on discharge NLR (mean 5.21), PLR (mean 183.7) were calculated which showed a significant decrease (p value of 0.000001) and (p value of 0.0028) respectively, but did not return to normal within 2 month period in all patients. Conclusion: Thus, decreasing or improving NLR and PLR ratios rather than return to normal ratio can be considered as a sign of improving patient condition, while an increasing NLR has shown to be associated with bad prognosis.
Keywords: Trend, Neutrophil-Lymphocyte ratio, Platelet-Lymphocyte ratio, Diabetic ulcer, Prognostic Marker, healing indicator
Edition: Volume 12 Issue 1, January 2023,
Pages: 802 - 806