Association between increased neutrophil-to-lymphocyte ratio and postoperative 1-year mortality in elderly patients with pertrochanteric hip fracture

Background and aim: This study aimed to examine the prognostic value of perioperative NLR level in terms of mortality in the first postoperative year in elderly patients undergoing hip fracture surgery. Method: A total of 236 patients (68.6% female and 31.4% male), who fit the inclusion criteria and underwent hip fracture surgery, were included in the study. The patients’ complete blood count taken at the time of admission and on the fifth postoperative day were recorded. NLR values calculated at admission (NLR-D0) and on the fifth postoperative day (NLR-D5) were determined as the main variable. Results: The mean age of the participants was 80.1 ± 7.9 years (min: 65 years to max: 99 years). The mean NLR-D0 and mean NLR-D5 values of surviving patients were 6.54 and 4.55, respectively. The mean NLR-D0 and mean NLR-D5 values of patients who died were 6.99 and 8.90, respectively. A significant difference was found in the NLR variability of the patients who survived and those who died. The examination of the effects of NLR-D0 and NLR-D5 parameters on mortality revealed no significant difference in NLR-D0 values between the patients who lived and those who died (P > 0.05), but the NLR-D5 value was significantly higher in the patients who died. The mortality rate at the end of the first postoperative year was 35.2%. Conclusion: A high NLR value (NLR-D5 >7.85) on the fifth postoperative day in elderly patients undergoing hip fracture surgery may be a predictor of 1-year mortality after hip fracture surgery.