Predictive value of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio for acute deep vein thrombosis after total joint arthroplasty: a retrospective study

BACKGROUND Deep vein thrombosis (DVT) is a common and severe complication of total joint arthroplasty (TJA). Inflammation has been proved to play a role in DVT. The neutrophil to lymphocyte ratio (NLR) and the platelet to lymphocyte ratio (PLR) are biomarkers for systemic inflammation. The aim of the study is to investigate the predictive value of NLR and PLR for acute TJA-induced DVT. METHOD A total of 773 patients who underwent primary TJA in our hospital were included in this retrospective study. Venography was performed routinely after the surgery to define acute DVT. NLR and PLR before and after operation were calculated according to the blood routine test. Multiple logistic regression analyses and ROC curve analyses were performed to assess the association of NLR and PLR with TJA-induced DVT. RESULTS One hundred twenty out of 773 patients (15.5%) were diagnosed with DVT by venography. In patients with DVT, preoperative NLR (P = 0.030) and postoperative NLR (P = 0.015) were significantly higher but postoperative PLR (P = 0.002) was significantly lower. Multiple logistic regression analyses indicated that age (OR = 1.05, P < 0.005), gender (OR = 0.47, P = 0.005), BMI (OR = 1.06, P < 0.014), preoperative NLR (OR = 1.11, P < 0.035), postoperative NLR (OR = 1.20, P < 0.001), and PLR (OR = 0.99, P < 0.001) were independently associated with DVT. However, the ROC curve analysis demonstrated the specificity and sensitivity of NLR or PLR in predicting DVT were low. CONCLUSION Although the present study demonstrated significant association of perioperative NLR or PLR with acute TJA-induced DVT, NLR or PLR cannot predict TJA-induced DVT accurately.