Association between neutrophile-to-lymphocyte ratio and risk of deep vein thrombosis in patient receiving lower extremity orthopedic surgery: A meta-analysis

I-Wen Chen, Wei-Ting Wang, Kuo-Chuan Hung

Abstract

This meta-analysis aimed to quantitatively synthesize evidence on the association between the preoperative neutrophil-to-lymphocyte ratio (NLR) and the risk of deep vein thrombosis (DVT) in patients undergoing lower extremity orthopedic surgery.

Introduction

Deep vein thrombosis (DVT) is a common and potentially life-threatening complication that often arises after lower extremity orthopedic surgery [1–4]. The incidence of DVT following such procedures ranges between 27.3% and 38.4% [5–7]. Importantly, DVT can also develop preoperatively in patients scheduled for lower-limb surgery [8], with reported incidence rates ranging from 24.1% to 32% [9,10].

Method

This meta-analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to ensure a comprehensive and transparent approach (S1 Table).

Results

The study selection process is summarized in Fig 1. The database search identified 150 records. After the removal of 15 duplicate records, 135 records were screened by title and abstract. Of these, 115 records were excluded because they did not meet the inclusion criteria based on the title and abstract review.

Discussion

This meta-analysis, encompassing 10 studies and 5,697 patients undergoing lower extremity orthopedic surgery, revealed several significant findings. The pooled incidence of DVT was 13.8%, underscoring its prevalence in this population. Notably, elevated NLR was associated with a two-fold increase in DVT risk (OR 2.08), with patients who developed DVT having, on average, a 0.93 unit higher NLR.

Conclusion

Our results indicate that patients with an elevated NLR have approximately double the odds of developing DVT than those with a lower NLR. This finding highlights the potential of NLR as an accessible and cost-effective biomarker for DVT risk assessment.

Citation: Chen I-W, Wang W-T, Hung K-C (2025) Association between neutrophile-to-lymphocyte ratio and risk of deep vein thrombosis in patient receiving lower extremity orthopedic surgery: A meta-analysis. PLoS ONE 20(2): e0319107. https://doi.org/10.1371/journal.pone.0319107

Editor: Eyüp Serhat Çalık, Ataturk University Faculty of Medicine, TÜRKIYE

Received: September 2, 2024; Accepted: January 27, 2025; Published: February 24, 2025

Copyright: © 2025 Chen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the paper and its Supporting information files.

Funding: The author(s) received no specific funding for this work.

Competing interests: The authors have declared that no competing interests exist.

 

Source: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0319107#abstract0