Relationship between peripheral blood neutrophil/lymphocyte ratio and the prognosis of patients with brittle femoral neck fracture

Objective:To explore the relationship between peripheral blood neutrophil/lymphocyte ratio(NLR)and osteoporotic femoral neck fractures and to evaluate the prognosis.Methods:The subjects were 102 patients who received osteoporotic femoral neck fracture in the First Affiliated Hospital of Guangzhou University of Chinese Medicine from 2008 to 2017.Patients were divided into three groups according to the BMD values in the diagnostic criteria of primary osteoporosis:normal bone mass group(T≥-1.0),reduced bone mass group(-2.5<T<-1.0)and osteoporosis group(T≤-2.5).In addition,during postoperative follow-up,patients receiving internal fixation were divided into the high NLR group(NLR>2.33)and the low NLR group(NLR≤2.33)according to their NLR values.The clinical data of patients with osteoporotic femoral neck fracture who underwent peripheral blood routine examination were prospectively analyzed.The statistical indicators included age,gender,fracture cause and other general conditions,fracture type,peripheral blood neutrophil/lymphocyte ratio,bone mineral density(BMD)level and blood lipid level,and prognosis of 102 patients who were followed up for more than 2 years after surgery.The relationship between peripheral blood NLR and the above indexes was observed.Statistical methods including normal data analysis of variance between groups,SNK-q test is compared between two groups,the partial correlation analysis between the two factors,the relationship between multiple factors using multi-factor linear regression analysis,and normal data comparison between the two groups using t test,two sets of independent data frequency distribution of binary classification variables compared by chi-square test.Moreover,NLR is also a major factor affecting the prognosis and rehabilitation of osteoporotic femoral neck fractures.Results:The analysis of variance between the two groups(SNK-q test of the comparison between the two groups),single-factor partial correlation analysis,multi-factor linear regression analysis showed that compared with the normal group and the reduced group,the levels of age,triglyceride and NLR in the osteoporosis group were increased,while BMD was significantly decreased.BMD in patients with osteoporotic femoral neck fracture was negatively correlated with NLR and triglyceride(P<0.05).In multi-factor linear regression analysis,NLR and triglyceride were the main influencing factors of BMD in patients with osteoporotic femoral neck(P<0.05).In addition,increased peripheral blood NLR in patients treated with internal fixation may increase the risk of postoperative femoral head necrosis,nonunion of the broken end of the fracture,and prolong the time of postoperative functional recovery.Conclusion:The level of peripheral blood NLR in patients with osteoporotic femoral neck fracture is increased and correlated with bone mineral density,which suggested that peripheral blood NLR can be used as one of the clinical indicators for early screening and prevention of osteoporotic femoral neck fracture.In addition,peripheral blood NLR is also a major factor affecting the prognosis and rehabilitation of osteoporotic femoral neck fractures.