摘要
目的探讨入院中性粒细胞与淋巴细胞比值(NLR)对老年髋部骨折患者预后的预测价值。方法连续纳入2014年1月—2019年12月收治的老年髋部骨折患者725例,收集患者的年龄、性别、骨折情况、治疗方式和实验室检查等临床资料。根据入院血常规结果计算NLR值,利用受试者工作特征(ROC)曲线确定NLR值的最佳截断值,将患者分为低NLR组和高NLR组。电话随访患者生存情况,Kaplan-Meier法绘制2组患者的生存曲线,Cox比例风险模型分析影响预后的危险因素。结果NLR值的最佳截断值为10.08,以此将患者分为低NLR组(NLR≤10.08,520例)和高NLR组(NLR>10.08,205例)。中位随访34.64个月(12~89个月),其中30 d内死亡45例(6.21%);6个月内死亡105例(14.48%);1年内死亡149例(20.55%)。与低NLR组相比,高NLR组30 d、6个月和1年病死率更高(均P<0.05)。多因素Cox回归分析显示,高NLR值、男性、Charlson合并症指数(CCI)≥1、保守治疗、白蛋白水平降低及血肌酐升高是影响老年髋部骨折患者1年内死亡的独立危险因素(均P<0.05)。结论入院NLR值可作为临床预测老年髋部骨折患者预后的指标。
Objective To investigate the predictive value of neutrophil to lymphocyte ratio(NLR)on admission for prognosis in elderly patients with hip fracture.Methods A total of 725 consecutive patients were retrospectively enrolled in this study from January 2014 to December 2019.Clinical data such as age,gender,fracture information,treatment and laboratory tests were collected.NLR was calculated based on the blood routine result on admission,and the receiver operating characteristic(ROC)curve was used to determine the optimal cut-off value of NLR.Patients were divided into low NLR group and high NLR group.Survival situation was obtained from telephone follow-up,and the survival curves of patients were plotted using the Kaplan-Meier method in high NLR and low NLR groups.Cox proportional hazard model was used to analyze the risk factors affecting the prognosis.Results The optimal cut-off value of NLR was 10.08.Patients were divided into low NLR group(NLR≤10.08,n=520)and high NLR group(NLR>10.08,n=205).The median follow-up time was 34.64 months(12~89 months),of which 45(6.21%)died within 30-day,105(14.48%)in 6-month and 149(20.55%)in 1-year.Compared with low NLR group,high NLR group showed higher fatality rates at 30-day,6-month and 1-year(all P<0.05).Multi-factor Cox regression analysis showed that high NLR value,male,Charlson comorbidity index(CCI)≥1,conservative treatment,reduced albumin and elevated serum creatinine were independent risk factors for the 1-year mortality in elderly hip fracture patients(all P<0.05).Conclusion The NLR value of admission can be used as a clinical indicator to predict the prognosis in elderly patients with hip fracture.
作者
王志聪
陈曦
杨灵
汪红
江伟
高博
刘跃洪
WANG Zhi-cong;CHEN Xi;YANG Ling;WANG Hong;JIANG Wei;GAO Bo;LIU Yue-hong(Orthopaedic Center of Deyang City,Department of Orthopaedics,Peoples's Hospital of Deyang City,Deyang 618000,China)
出处
《天津医药》
CAS
北大核心
2021年第8期865-869,共5页
Tianjin Medical Journal
基金
德阳市科技计划项目(2019SZ125)。
