title: Predictive value of neutrophil-to-lymphocyte ratio in diabetic wound healing.
abstract: The neutrophil-to-lymphocyte ratio (NLR) has been used as a surrogate marker of systemic inflammation. We sought to investigate the association between NLR and wound healing in diabetic wounds.
  
  
  
  The outcomes of 120 diabetic foot ulcers in 101 patients referred from August 2011 to December 2014 were examined retrospectively. Demographic, patient-specific, and wound-specific variables as well as NLR at baseline visit were assessed. Outcomes were classified as ulcer healing, minor amputation, major amputation, and chronic ulcer.
  
  
  
  The subjects' mean age was 59.4 ± 13.0 years, and 67 (66%) were male. Final outcome was complete healing in 24 ulcers (20%), minor amputation in 58 (48%) and major amputation in 16 (13%), and 22 chronic ulcers (18%) at the last follow-up (median follow-up time, 6.8 months). In multivariate analysis, higher NLR (odds ratio, 13.61; P = .01) was associated with higher odds of nonhealing.
  
  
  
  NLR can predict odds of complete healing in diabetic foot ulcers independent of wound infection and other factors.
authors.affiliation: Division of Vascular Surgery, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Ore. Electronic address: vatankha@ohsu.edu.
authors.forename: Nasibeh
authors.initials: N
authors.lastname: Vatankhah
authors.affiliation: Dotter Interventional Institute, Oregon Health & Science University, Portland, Ore.
authors.forename: Younes
authors.initials: Y
authors.lastname: Jahangiri
authors.affiliation: Division of Vascular Surgery, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Ore.
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Landry
authors.affiliation: Division of Vascular Surgery, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Ore.
authors.forename: Robert B
authors.initials: RB
authors.lastname: McLafferty
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Ore.
authors.forename: Nabil J
authors.initials: NJ
authors.lastname: Alkayed
authors.affiliation: Division of Vascular Surgery, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Ore.
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Moneta
authors.affiliation: Division of Vascular Surgery, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Ore.
authors.forename: Amir F
authors.initials: AF
authors.lastname: Azarbal
mesh_terms: D000368:Aged; D000671:Amputation, Surgical; D019540:Area Under Curve; D002908:Chronic Disease; D017719:Diabetic Foot / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D023821:Limb Salvage; D016015:Logistic Models; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009504:Neutrophils / Q000276:immunology*; D016017:Odds Ratio; D009922:Oregon; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing