title: Neutrophil to lymphocyte ratio may be a predictive marker of poor prognosis in Legg-Calvé-Perthes disease.
abstract: BACKGROUND
  Legg-Calvé-Perthes disease (LCPD) is the idiopathic avascular necrosis of the femoral head in childhood. The pathologic changes seen in the femoral head are likely a result of vascular factors. Blood neutrophil to lymphocyte (N/L) ratio is a simple marker of subclinical inflammation. This study aims to to analyse the predictive ability of N/L ratio for the prognosis in LCPD patients.
  
  
  METHODS
  Patients who had been diagnosed as LCPD from 2008 to 2014 were investigated retrospectively and 40 LCPD patients (33 male and 7 female) and 25 healthy age and sex-matched children (controls) were included in the study. LCPD patients were divided into 2 groups according to expected prognosis (good prognosis expected Herring A and B patients as Group I and poor prognosis expected Herring B-C and C patients as Group II) and healthy children (control) were included in Group III. All the patients' hematological markers were analysed.
  
  
  RESULTS
  Mean age was 7.1 ± 2.0 years in group I (4.9-12 years), 8.3 ± 2.2 years (4-12.5 years) in group II and 7.8 ± 1.3 years (6-12 years) in group III. Mean values for Groups I, II and III for neutrophil to lymphocyte (N/L) ratio were 1.13 ± 0.65, 1.75 ± 0.95, 1.08 ± 0.37, respectively. The mean neutrophil to lymphocyte (N/L) ratio of Group II was higher than the other 2 groups (p = 0.003).
  
  
  CONCLUSIONS
  N/L ratio may give us information about the natural course of LCPD and may be used as independent predictor of prognosis in patients with LCPD.
authors.affiliation: Department of Orthopaedics and Traumatology, Çanakkale Onsekiz Mart University, Medical School, Çanakkale - Turkey.
authors.forename: Burak
authors.initials: B
authors.lastname: Kaymaz
authors.affiliation: Department of Orthopaedics and Traumatology, Hacettepe University, Medical School, Ankara - Turkey.
authors.forename: Kadir
authors.initials: K
authors.lastname: Büyükdogan
authors.affiliation: Department of Paediatrics, Çanakkale Onsekiz Mart University, Medical School, Çanakkale - Turkey.
authors.forename: Nazan
authors.initials: N
authors.lastname: Kaymaz
authors.affiliation: Department of Orthopaedics and Traumatology, Çanakkale Onsekiz Mart University, Medical School, Çanakkale - Turkey.
authors.forename: Erkam
authors.initials: E
authors.lastname: Kömürcü
authors.affiliation: Department of Orthopaedics and Traumatology, Çanakkale Onsekiz Mart University, Medical School, Çanakkale - Turkey.
authors.forename: Umut Hatay
authors.initials: UH
authors.lastname: Golge
authors.affiliation: Department of Orthopaedics and Traumatology, Çanakkale Onsekiz Mart University, Medical School, Çanakkale - Turkey.
authors.forename: Ferdi
authors.initials: F
authors.lastname: Goksel
authors.affiliation: Department of Orthopaedics and Traumatology, Hacettepe University, Medical School, Ankara - Turkey.
authors.forename: Mehmet Cemalettin
authors.initials: MC
authors.lastname: Aksoy
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007873:Legg-Calve-Perthes Disease / Q000097:blood* / Q000175:diagnosis*; D007958:Leukocyte Count; D008214:Lymphocytes; D008297:Male; D009504:Neutrophils; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies