The Journal of Hip Surgery 2022; 06(03): 136-142
DOI: 10.1055/s-0042-1756278
Original Article

NLR as a Prognostic Tool in Orthopaedic Surgery in Elderly Extra-Articular Hip Fracture: A Significant Increase in NLR 24 Hours after Surgical Intervention

Laura Tomaino
1   Emergency Medicine Residency Program, Marche Polytechnic University, Ancona, Italy
Simone Pansieri
2   Clinical Orthopaedics, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy
Luisella Vigna
3   Department of Preventive Medicine, Occupational Health Unit “L. Devoto,” Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
Carlo La Vecchia
4   Department of Clinical and Community Sciences (DISSCO), Università degli Studi di Milano, Italy
Lidia Da Lio
5   Laboratory Medicine, Azienda Ospedaliera Universitaria Ospedali Riuniti, Marche Polytechnic University, Ancona, Italy
Gianluca Moroncini
6   Clinica Medica, Azienda Ospedaliera Universitaria Ospedali Riuniti, Marche Polytechnic University, Ancona, Italy
Antonio Pompilio Gigante
2   Clinical Orthopaedics, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy
› Author Affiliations


Neutrophil-to-lymphocyte ratio (NLR) was developed as a diagnostic and prognostic tool in many medical conditions, and its use is spreading as a predictor of postoperative outcome in orthopaedic surgery. The aim of this study is to investigate the improvement of NLR 24 hours after surgical intervention in a cohort of 91 patients (F/M = 68/23) with hip fracture who underwent femur intramedullary fixation. Patients were 84.7 ± 7.9 years old, and the mean hospital stay was 13.4 ± 4.7 days, with a mean delay to surgery of 1.9 ± 1.4 days. A significant increase in NLR between baseline (T0) and 24 hours after surgical intervention (T1) was observed in the study sample overall and on subgroup analysis by gender. Nevertheless, no significant effect of NLR on the length of hospital stay was observed.

Authors' Contributions

L.T., S.P., and L.V. had the idea of the study and prepared the first version of the manuscript. L.T., S.P., and L.D.L. retrieved data and prepared the dataset. L.T. run the data analyses and, together with S.P., L.V., and C.L.V., wrote this article, setting up the English version of the manuscript, tables and figures, and their final version. G.M. and A.P. G. collaborated to the final version of the manuscript, with some advises as mentors. L.V. and C.L.V. critically revised the manuscript giving their useful suggestions.

Publication History

Received: 01 February 2022

Accepted: 13 July 2022

Article published online:
08 September 2022

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