ArticleOrthopaedic surgery2025
Neutrophil-Lymphocyte Ratio as Predictor for Acute Infection After Primary Total Joint Arthroplasty in Rheumatoid Arthritis Patients.
Article in Orthopaedic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Composite inflammatory, immune, and nutritional indices for predicting surgical site infection following spine surgery: a systematic review with narrative synthesis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Review
- High baseline neutrophil-to-lymphocyte ratio is associated with better adalimumab response in patients with rheumatoid arthritis.The Journal of international medical research · 2026Article
- Association of Anemia Severity with Distinct Microbial and Inflammatory Signatures in Patients Receiving Vancomycin.Healthcare (Basel, Switzerland) · 2026Article
- The Geriatric Nutritional Risk Index Is an Independent Predictor of Prosthesis Aseptic Loosening in Patients Undergoing Total Joint Arthroplasty.Orthopaedic surgery · 2026Article
- Correlation of Neutrophil-Lymphocyte Ratio and Critical Illness in Adults on Vancomycin: A Cross-Sectional Study.International journal of general medicine · 2025Article
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Authors and funding
7 authors.
Funding
Abstract
objectivesPreoperative levels of certain inflammatory markers in the blood can predict acute infection after primary total joint arthroplasty in patients without inflammatory disease, but whether they can do so in patients with rheumatoid arthritis is unclear. The objectives of this study were to determine whether, with appropriate cut-off values, (1) preoperative levels of NLR predicted postoperative acute infection; and (2) preoperative plasma fibrinogen, monocyte-lymphocyte ratio, C-reactive protein or erythrocyte sedimentation rate predicted postoperative acute infection.
methodsWe retrospectively analyzed 964 patients with rheumatoid arthritis who underwent primary total joint arthroplasty at our hospital between January 2010 and November 2020. We compared preoperative levels of inflammatory markers including neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), plasma fibrinogen (FIB) between patients who suffered acute infection or not within 90 days after surgery. The ability of markers to predict infection was assessed in terms of the area under receiver operating characteristic curves (AUC) based on optimal cut-off values determined from the Youden index.
resultsAmong the 964 patients, 27 (2.8%) experienced acute infection. Preoperative levels of individual inflammatory markers predicted infection with the following AUCs and cut-off values: NLR, 0.704 (cut-off: 2.528); MLR, 0.608 (0.2317); CRP, 0.516 (4.125 mg/L); ESR, 0.533 (66.5 mm/h); and FIB, 0.552 (3.415 g/L). The neutrophil-lymphocyte ratio showed diagnostic sensitivity of 92.6% and specificity of 43.3%, while the monocyte-lymphocyte ratio showed sensitivity of 77.8% and specificity of 46.3%.
conclusionThe preoperative NLR shows some ability to predict acute infection after total joint arthroplasty in patients with rheumatoid arthritis. Monitoring this ratio, perhaps in conjunction with other markers not analyzed here, may be useful for optimizing the timing of surgery in order to minimize risk of postoperative infection.
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