SynthesisJournal of orthopaedic surgery and research2025
Neutrophil-to-lymphocyte ratio for predicting postoperative mortality after hip fracture surgery: a systematic review and meta-analysis.
Synthesis in Journal of orthopaedic surgery and research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Association of multidimensional biomarkers of immune, nutritional, inflammatory, and metabolic status with postoperative outcomes in older hip fracture patients: a systematic review and meta-analysis.Frontiers in nutrition · 2026Pooled it
- Evaluation of short- and long-term mortality prediction in patients undergoing hip fracture surgery using a biomarker-based interpretable predictive modeling approach: a retrospective cohort analysis.BMC medical informatics and decision making · 2026Article
- Association of Early Postoperative Biochemical Markers with a Composite Adverse Perioperative Outcome After Bariatric Surgery.Diagnostics (Basel, Switzerland) · 2026Article
- Preoperative Geriatric Nutritional Risk Index (GNRI) and Comorbidity Burden as Mortality Risk Markers After Proximal Femoral Nailing in Older Patients with Pertrochanteric Hip Fractures.Journal of clinical medicine · 2026Article
- The Association Between Systemic Inflammatory and Metabolic Indices and Early Adverse Clinical Outcomes in Adult Patients Admitted to the Post-anaesthesia Care Unit: A Retrospective Observational Study.Turkish journal of anaesthesiology and reanimation · 2026Article
- Development and multicenter validation of a dynamic nomogram for early postoperative neurocognitive disorder in older adults with hip fracture.BMC geriatrics · 2026Article
- Sudden Cardiac Arrest in Proximal Femur Fracture: The Role of Admission Blood Parameters.Cureus · 2026Article
- From serum inflammatory markers to fluid, tissue, and molecular assays: current advances in the laboratory diagnosis of bone and joint infections.Frontiers in cellular and infection microbiology · 2026Review
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe current study aimed to systematically and quantitatively evaluate the prognostic value of the neutrophil-to-lymphocyte ratio (NLR) in predicting mortality among surgical patients with hip fractures through a systematic review and meta-analysis.
designSystematic review and meta-analysis.
methodsFour databases-The Cochrane Library, PubMed, Embase, and Web of Science-were comprehensively retrieved to identify studies published from database inception to May 2025 that investigated NLR as a predictor of postoperative survival in hip fracture individuals. Two independent researchers performed study selection, data extraction, and quality assessment, with consistency verified via cross-checking. Statistical analyses were performed using Stata 15.0 for meta-regression and heterogeneity testing, while prognostic performance metrics (sensitivity, area under the curve [AUC], specificity) were synthesized via Meta-Disc 1.4.
resultsOur meta-analysis incorporated 12 studies, involving 10,015 individuals who underwent surgery for a hip fracture. With cut-off values ranging from 3.2 to 8.4, preoperative NLR demonstrated high prognostic efficacy for mortality prediction, yielding a combined sensitivity of 0.69 (95% CI 0.55-0.83), specificity of 0.84 (0.74-0.93), diagnostic odds ratio (DOR) of 12 (6-26), and an area under the summary receiver operating characteristic curve (sAUC) of 0.84 (0.81-0.87). Subgroup analysis of preoperative NLR thresholds revealed that higher cut-off values (NLR > 5) significantly improved prognostic performance. NLR exhibited superior sensitivity but slightly lower specificity in patients from developing countries, with particular prognostic utility for long-term mortality (≥ 1 year). Postoperative NLR showed moderate prognostic efficacy, with a combined sensitivity of 0.64 (0.57-0.70), specificity of 0.58 (0.55-0.61), DOR of 2 (2-3), and sAUC of 0.62 (0.58-0.66).
conclusionThis meta-analysis confirms that the preoperative NLR is a promising albeit preliminary predictor of postoperative mortality in hip fractures.
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