Research Information System
EXPERIMENTAL AND THERAPEUTIC MEDICINE, vol.28, no.235, pp.1-9, 2024 (SCI-Expanded)
Abstract. The present retrospective study aimed to inves‑
tigate the value of blood parameters in predicting mortality
in patients with below‑knee amputation (BKA). A total of
178 patients with BKA were included in the present study.
The patients were divided into two groups, namely the exitus
group (n=136; 76.4%) and the survivors group (n=42; 23.6%).
Patients in the exitus group were further divided into three
subgroups: i) Those who experienced mortality in <1 month
(n=55; 40.4%); ii) those who experienced mortality between
1‑12 months (n=48; 35.3%); and iii) those who experienced
mortality in >12 months after surgery (n=33; 24.3%). Binary
logistic regression and a generalized linear model were used for
relational analysis, and a receiver operator characteristic curve
was used for diagnostic tests. It was found that the parameters of
age (B=0.061; P=0.01), eosinophil‑to‑lymphocyte ratio (ELR)
(B=‑2.861; P<0.05), C‑reactive protein (CRP)/albumin ratio
(B=0.027; P<0.01) and mean platelet volume (MPV)/lympho‑
cyte ratio (B=0.310; P<0.01) had a significant effect on mortality
at the multivariate level. Moreover, regression coefficients
showed that the effect of age, CRP/albumin and MPV/lympho‑
cyte ratios on mortality were positive, whereas the effect
of the ELR was negative. The mortality predictive values
of age [area under the curve (AUC)=0.681; P=0.01], ELR
(AUC=0.630; P=0.01), CRP/albumin ratio (AUC=0.746;
P=0.01) and MPV/lymphocyte ratio (AUC=0.676; P<0.01)
were also found to be statistically significant. For the 27.51
CRP/albumin cut‑off value, the sensitivity was found to
be 80.1%, whereas the specificity was 54.8%. For the 36.93
CRP/albumin cut‑off value, the sensitivity was 71.3%, and the
specificity was 73.8%. Furthermore, MPV (B=‑0.37; P<0.01)
and hemoglobin/red‑blood‑cell distribution width (RDW) ratio
(B=5.20; P<0.01) were found to have a significant effect on the
time to death at the multivariate level. The parameters MPV
(AUC=0.648; P<0.01) and hemoglobin/RDW (AUC=0.673;
P=0.01) had predictive value in terms of the time to death. The
predictive value for MPV was found to be 64.8%, whereas that
for the hemoglobin/RDW ratio was 67.3%. For the 0.54 cut‑off
value for hemoglobin/RDW, the sensitivity was 74.5%, and the
specificity was 11.1%. By contrast, for the 0.84 cut‑off value
for the hemoglobin/RDW ratio, the sensitivity was 10.9% and
the specificity was 81.5%. In conclusion, the CRP/albumin
ratio was identified as a significant mortality parameter,
whereas the hemoglobin/RDW ratio was a significant time to
death predictor, according to the results of the present analysis.
These results may guide clinical practices and further research
in terms of predicting mortality in patients with BKA