Study on Lymphocyte-to-C-reactive Protein Ratio (LCR) and Its Impact on Elderly Patients Undergoing Hemiarthroplasty

The low level of preoperative Lymphocyte-to-C-reactive protein (CRP) ratio (LCR) can effectively predict 1-year mortality and 30-day total complications after surgery in elderly patients with displaced femoral neck fracture undergoing hemiarthroplasty, suggests a recent study published in the Journal of Orthopaedic Surgery and Research.

Lymphocyte-to-C-reactive protein (CRP) ratio (LCR) is a novel biomarker for predicting poor prognosis in many diseases. This study aims to analyze the association between preoperative LCR and 1-year mortality in elderly patients with displaced femoral neck fracture undergoing hemiarthroplasty.

Between May 2017 and May 2019, a retrospective study including 364 elderly patients undergoing hemiarthroplasty for displaced FNF was performed. LCR was defined as the ratio of preoperative lymphocyte count to CRP level. The optimal cutoff value of LCR was determined by receiver operating characteristic curve, and all patients were categorized into low-LCR group and high-LCR group accordingly. The relationship between LCR and 1-year mortality was evaluated by using univariate and multivariate Cox regression analysis. Furthermore, the complications within 30 days after surgery, length of hospital stay, and perioperative red blood cell transfusion were also analyzed stratified by LCR.

Results

• A total of 47 patients (12.9%) died within 1-year follow-up after surgery.
• The optimal cutoff value for LCR was 30,560.
• Low-LCR (≤ 30,560) group had a higher mortality rate than high-LCR group.
• In multivariate analysis, low LCR, hypoalbuminemia, and Age-Adjusted Charlson Comorbidity Index ≥ 6 were identified as independent predictors for 1-year mortality.
• Moreover, low level of LCR was associated with high rate of total complications, perioperative transfusions, and longer hospital stay.

The low level of preoperative LCR can effectively predict 1-year mortality and 30-day total complications after surgery in elderly patients with displaced FNF undergoing hemiarthroplasty.

Reference

Zhu, J., Cheng, X., Li, Y. et al. Low lymphocyte-to-C-reactive protein ratio relates to high 1-year mortality in elderly patients undergoing hemiarthroplasty for displaced femoral neck fracture. J Orthop Surg Res 17, 512 (2022). https://doi.org/10.1186/s13018-022-03406-9

Keywords

Zhu, J., Cheng, X., Li, Y, Low, lymphocyte-to-C-reactive, protein, ratio, relates, high 1-year, mortality, elderly patients, undergoing, hemiarthroplasty, displaced, femoral neck fracture, Journal of Orthopaedic Surgery and Research, Elderly, Femoral neck fracture, Hemiarthroplasty, Mortality, Lymphocyte-to-C-reactive protein ratio