Open Access

Neutrophil-to-Lymphocyte Ratio – Risk of Amputation and Mortality in Patients with Limb-Threatening Ischemia – a Systematic Review


Cite

FIGURE 1.

PRISMA flow chart of studies included in the systematic review
PRISMA flow chart of studies included in the systematic review

Disease etiology, treatment, and outcomes of patients with ALI

Study Study group value Control group value Cut-off value AUC/ROC analysis Sensitivity (%) Specificity (%) Outcome
ALI

Taşoğlu et al.27 9.7 6.1 5.2 0.7 63% 63% Amputation
Coelho et al.28 8.8 3.6 5.4 0.860 90.5% 73.6% Death or major amputation at 30 days
Taurino et al.29 5 0,823 Amputation at 30 days
5 0.776 Mortality at 30 days
Pasqui et al.30 8.9 6.5 6.66 0.712 77.8% 65.3% Amputation at 26.9 ± 22.1 months
8.08 5.6 5.57 0.639 62.3% 56.04% Mortality at 26.9 ± 22.1 months
Arbănași et al.31 5.78 2.61 4.23 0.829 70.2% 83% Major amputation at 30 days

CLTI

Spark et al.32 5.25 0.690 69% 71% Mortality at 8.7 months (3.1–16 months)
Chan et al.33 5.25 Mortality at 12 months
Gonzalez-Fajardo et al.34 5 0.64 32% 87.5% Amputation-free survival at 31 months
Erturk et al.35 3 Cardiovascular death at 20 months (12–27 months)
Taşoğlu et al.36 3.8 2.4 3.2 0.71 Major amputation at 46 months
Su et al.37 8 62% 82.1% Mortality at 12 months
Russu et al.38 6.40 2.21 3.95 0.821 82.6% 89.9% Primary patency at 12 months

Clinical cases and surgical procedures for ALI

Study Cause Location Treatment Complication

Embolic, n (%) Thrombotic, n (%) Aorto-iliac, n (%) Femoral-popliteal axis, n (%) Below the knee artery, n (%) Embolectomy, n (%) Bypass, n (%) Other, n (%) Amputation, n (%) Mortality, n (%)
Taşoğlu et al.27 224 (92%) 21 (8%) 44 (18%) 189 (78%) 224 (92%) 21 (8%) 36 (14.69%) 25 (10%)
Coelho et al.28 157 (45.5%) 188 (54.5%) 60 (17.4%) 261 (75.7%) 24 (7%) 280 (81.2%) 35 (10.1%) 30 (8.7%) 84 (24.34%)
Taurino et al.29 73 (41.3%) 104 (58.7%) 95 (53.7%) 9 (5.1%) 73 (41.2%) 23 (12.9%) 29 (16.4%)
Pasqui et al.30 67 (39.9%) 121 (60.1%) 19 (11.3%) 138 (82.1%) 11 (6.5%) 18 (10.7%) 77 (45.8%)
Arbănași et al.31 118 (72.39%) 38 (23.31%) 7 (4.29%) 57 (27.14%) 47 (22.38%)

The general characteristics of the studies included in the review

Study Year Country No. of patients Mean age (years) Male sex, n (%) Hypertension, n (%) Ischemic heart disease, n (%) Diabetes, n (%) Active smoking, n (%)
ALI

Taşoğlu et al.27 2013 Turkey 245 66.04 152 (62%) 144 (59%) 60 (24%) 170 (70%)
Coelho et al.28 2021 Portugal 345 73 188 (54.5%) 277 (83.5%) 157 (45.5%) 92 (27.5%) 136 (39.4%)
Taurino et al.29 2021 Italy 177 78.9 115 (65%) 145 (81.9%) 70 (39.5%)
Pasqui et al.30 2021 Italy 168 77.8 109 (64.9%) 128 (76.1%) 45 (26.7%) 54 (32.1%) 18 (10.7%)
Arbănași et al.31 2022 Romania 210 69.56 153 (72.86%) 175 (83.33%) 169 (80.48%) 111 (52.86%) 134 (63.81%)

CLTI

Spark et al.32 2010 UK 149 72 83 (55.7%) 44 (29.53%) 103 (69.12%)
Chan et al.33 2014 Australia 97 81 50 (64.9%) 42 (54.6%) 49 (63.6%) 46 (59.7%)
Gonzalez-Fajardo et al.34 2014 Spain 561 74 465 (83%) 354 (63.10%) 131 (23.35%) 258 (45.98%) 362 (64.52%)
Erturk et al.35 2014 Turkey 508 64 413 (81.3%) 311 (61.22%) 207 (40.74%) 213 (41.92%) 266 (52.36%)
Taşoğlu et al.36 2014 Turkey 104 69 86 (82.7%) 46 (44.2%) 39 (37.5%) 74 (71.2%)
Su et al.37 2021 Taiwan 195 74 102 (52.3%) 129 (66.15%) 75 (38.46%) 134 (68.71%) 46 (23.58%)
Russu et al.38 2022 Romania 224 69.72 166 (74.11%) 186 (83.04%) 181 (80.8%) 110 (49.11%) 141 (62.95%)
eISSN:
2457-5518
Language:
English