TITLE:
The Preoperative Neutrophil-to-Lymphocyte Ratio as a Predictor of Infectious Complications after Lower Limb Amputation in Diabetic Patients in Tropical Environments
AUTHORS:
Kone Samba, Kouassi Kouamé Jean-Eric, Kouassi Aya Adélaide Natacha, Koffi Appagny OI Appagny Fabrice Eric, Akobé Achié Jean-Regis, Kone Seydou, Kodo Michel
KEYWORDS:
Amputation, Diabetic Foot, Infection, Lower Limb, Neutrophil-to-Lymphocyte Ratio, NLR
JOURNAL NAME:
Open Journal of Orthopedics,
Vol.15 No.7,
July
29,
2025
ABSTRACT: Background: Infections of the lower limb in diabetics patients are challenging injuries to treat. Amputation often leads to treatment major. However, the risk of complications remains high after amputation. The aim of this study was to elucidate the correlations of the preoperative neutrophil/lymphocyte ratio (NLR) with wound complications after amputation. Methods: This study included patients who underwent lower extremity amputations due to diabetes from January 2023 to June 2024 at University Teaching Hospital Cocody, Ivory Coast. Factors associated with postoperative infection after amputation were assessed by univariate and multivariate analysis. Results: We undertook one hundred and twenty amputations (n = 120) of lower limbs over the period of study. Here are 63 (52.5%) men. The mean age was 62.34 ± 11.36 (37 - 91) years. Of 120 patients, 95 (79.2%) patients had a high NLR preoperatively. The majority of 88 (73.3%), underwent below-knee amputation. The postoperative infection rate as 71 (59.2%). In univariate analysis, a higher neutrophil and lymphocyte count preoperatively was associated with postoperative infection (p = 0.001). Preoperatively, a higher NLR was also associated with postoperative infection (p = 0.0001). Logistic regression analysis showed that age and high preoperative NLR (p Conclusion: Preoperative NLR identifies diabetic patients at increased risk of infection after major limb amputation. This simple index may facilitate targeted preventive measures for high-risk patients.