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Can ratio of neutrophil-tolymphocyte count and erythrocyte sedimentation rate in diabetic foot infection predict osteomyelitis and/or amputation?

Oktay Yapıcı, Hande Berk, Nefise Öztoprak, Derya Seyman, Alper Tahmaz, Alparslan Merdin
  • Oktay Yapıcı
    Infectious Diseases and Microbiology Clinic, Antalya Education and Research Hospital, Antalya, Turkey | yapicio@hotmail.com
  • Hande Berk
    Infectious Diseases and Microbiology Clinic, Antalya Education and Research Hospital, Antalya, Turkey
  • Nefise Öztoprak
    Infectious Diseases and Microbiology Clinic, Antalya Education and Research Hospital, Antalya, Turkey
  • Derya Seyman
    Infectious Diseases and Microbiology Clinic, Antalya Education and Research Hospital, Antalya, Turkey
  • Alper Tahmaz
    Infectious Diseases and Microbiology Clinic, Antalya Education and Research Hospital, Antalya, Turkey
  • Alparslan Merdin
    Internal Medicine Clinic, Antalya Education and Research Hospital, Antalya, Turkey

Abstract

The aim of this study was to search for any relations between the neutrophil-tolymphocyte ratio (NLR) and the development of osteomyelitis and the need for amputation in patients with diabetic foot infection (DFI). All data included DFI patients who were hospitalized in our Infectious Diseases Clinic between 2012 and 2015 and who were classified according to International Classification Disease Code System. 75 patients were analyzed in the study. The DFI patients were stratified into 3 groups of whom had amputation procedure, whom had only debridement/drainage procedure and whom had any surgery procedure. Sidac post hoc analysis was used to perform the effects of NLR, C-reactive protein, erythrocyte sedimentation rate and glycosylated hemoglobin on the surgery procedure status. The DFI patients were also stratified into two another separate group for another analysis to search for the effect of NLR values on the development of osteomyelitis. The mean value of NLR in the amputated patients’ group (15.7±10.3 was significantly higher than those with debridement procedure (9.9±5.6) and those without any surgery (6.0±2.8) (P=0.001). NLR values were also found significantly higher in patients with osteomyelitis in the second analysis (P=0.004). In this study, the NLR was found to have a predictive value on the development of osteomyelitis and on the progression to amputation in patients with DFI.

Keywords

Neutrophil to lymphocyte count; diabetic foot infection; osteomyelitis; amputation

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Submitted: 2016-11-18 22:45:35
Published: 2017-02-23 11:54:00
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Copyright (c) 2017 Oktay Yapici, Hande Berk, Nefise Öztoprak, Derya Seyman, Alper Tahmaz, Alparslan Merdin

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