Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio relation with outcomes in acute lower limb ischemia

Introduction: neutrophil/lymphocyte (NLR) and platelet/lymphocyte (PLR) ratio are markers of systemic inflam-mation and may correlate with major outcomes in patients with acute lower limb ischemia. Methods: a retrospective, analytic and multicenter study in a cohort of patients with acute lower limb ischemia, not traumatic or iatrogenic, between 2017 and 2018. Clinical and paraclinical data were analyzed, the NLR and PLR were calculated on admission and their relationship with amputation and death was sought. In addition, these outcomes were monitored up to 24 months after the event. Results: 140 patients were identified, 56 % was male and they had a mean age of 76 years old. An NLR > 5,2 is a risk factor for intra-hospital amputation (OR: 3,16) and for survival free of minor amputation (HR: 3,75). An NLR > 8,4 is a risk factor for in-hospital mortality (OR: 6,38) and for a lower overall survival (HR: 2,58). Further-more, PLR > 208 is associated with a minor amputation-free survival (HR: 1,93) and a PLR > 226 is correlated with greater hospital mortality (OR 4,48) and is a risk factor for a lower overall survival (HR: 2,33). It was also found that a classification of Rutherford IIb or III at admission, ages > 60 years and/or history of chronic kidney disease were associated with higher intra-hospital mortality. Conclusions: high values in the NLR and PLR are associated with increased risk of amputation and hospital mor-tality and are risk factors for free survival of amputation and reduced overall survival in patients with acute lower limb ischemia. Therefore, it can be used as one more tool when we're staging high-risk patients who are admitted with such a diagnosis.