Neutrophil to lymphocyte (NTL) ratio and its prognostic significance in patients with diabetic foot syndrome (DFS)

Abstract

BACKGROUND & OBJECTIVE: Neutrophil to lymphocyte ratio has an important role to predict the outcome of diabetic foot in patients with diabetic foot syndrome. The aim of this work is to evaluate the role of neutrophil to lymphocyte ratio as a prognostic factor in diabetic foot syndrome and its importance in forecasting fate of the diabetic wounds. METHODOLOGY: It was a descriptive cross-sectional study to evaluate role of neutrophil to lymphocyte ratio for prognosis of diabetic foot syndrome. All the cases were assessed for history of smoking, body mass index (BMI), presence of wound, glycated hemoglobin level, peripheral limb ischemia and infection. The patients were examined for a period of 12 months to assess the wound if it resulted in minor amputation (below the level of ankle), major amputations (below knee or above knee amputation), chronic wound or completely healed wound. The Chi-Square test was applied for categorical data. RESULTS: A total of 100 patients were part of the study. 61% of them were smokers. Average BMI was 31.7 in males and 34.5 in females. There was complete wound healing in 18% of cases after debridement. 16% of the subjects had to undergo major (above ankle) and 51% of the patients had to undergo minor (below ankle) amputations and chronic wounds in 15% of the patients. Mean neutrophil to lymphocyte count was 3.5 in cases of fully healed wounds, 6.9 in major amputations, 5.2 in minor amputations and 4.3 in cases of chronic wounds. As the p-value indicates, there is a significant relationship between healed wounds, minor amputations, Chronic wounds and major amputations and the NTL ratio. CONCLUSION: The result has revealed that NTL ratio has independent prognostic importance in diabetic foot syndrome for anticipating the wound upshot. The NTL ratio has a significant link with healed wounds, minor amputations, and major amputations, as indicated by the p-value.

Keywords

• Neutrophil to lymphocyte ratio
• Diabetic foot syndrome
• Below knee amputation
• Above knee amputation