Correlation Between Neutrophil-Lymphocyte Ratio and Inhospital Cardiac Events in Geriatric Patients With Hip Fractures

Abstract

Background: The novel inflammatory biomarker known as the neutrophil-lymphocyte ratio (NLR) has shown great potential in predicting and prognosing many diseases. However, its correlation with postoperative inhospital major adverse cardiac events (MACEs) in geriatric patients with hip fractures remains unclear. This study investigated the relationship between NLR and postoperative inhospital MACEs among geriatric patients with hip fractures. Methods: We enrolled geriatric patients with hip fractures who were hospitalized in the Department of Geriatric Traumatology and Orthopedics, Beijing Jishuitan Hospital, Capital Medical University, between January 2023 and November 2023. After surgery, the patients were transferred to the intensive care unit (ICU) for postoperative monitoring and treatment. Patients were assigned to the MACE or non-MACE group based on the occurrence of MACEs after surgery during their hospital stay. Clinical data were retrospectively analyzed. Results: In all, 216 patients were recruited into the study: 34 in the MACE group and 182 in the non-MACE group. Univariate and multivariate analyses revealed that a medical history of stroke (odds ratio (OR) = 2.66, 95% confidence interval (CI) = 1.18-6.01; p=0.018) and elevated preoperative NLR (OR = 1.09, 95% CI = 1.03-1.17; p=0.005) were significant risk factors for postoperative inhospital MACEs. The area under the curve (AUC) of preoperative NLR-predicted MACEs was 0.65 (0.55-0.75). Patients with a preoperative NLR <6.49 were less likely to experience inhospital MACEs, demonstrating a sensitivity of 61.8% and specificity of 64.8%. Conclusion: Elevated preoperative NLR is an independent risk factor for postoperative inhospital MACEs in geriatric patients with hip fractures.

Keywords: MACE; NLR; elderly; hip fracture.

Figure 1

Flowchart of the study. ICU, intensive care unit; MACE, major adverse cardiac event.

Figure 2

ROC curve for the predictive ability of preoperative NLR for MACE. MACE, major adverse cardiac event; NLR, neutrophil–lymphocyte ratio; ROC, receiver operating characteristic.