Red cell distribution width, eosinophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio can predict the development of infection and the number of antibiotics used in elderly patients undergoing revision total knee arthroplasty

Abstract

Introduction: We aimed to evaluate the relationship between complete blood parameters reported to be associated with inflammation and development of complications, length of hospital stays and the number of antibiotics used in elderly patients undergoing revision total knee arthroplasty (rTKA). Material and Method: Our retrospective study was conducted in a single center and included 72 older patients who underwent rTKA operations. We recorded patients’ firs day preoperative, first day postoperative and 45th day postoperative whole blood parameters. Results: It was found that the development of postoperative infection and the number of antibiotics used were higher in patients with low preoperative Hb values and high platelet-to-lymphocyte ratio (PLR) rates. In patients with high RDW value and high eosinophil-lymphocyte ratio (ELR) one day after surgery, both the development of infection (P=0.002, P=0.002) and the number of antibiotics used during follow-up were found to be significantly higher ​(P<0.001, P<0.001). When the laboratory parameters were evaluated 45 days after the operation, it was determined that the RDW (P=0.001, P=0.001) and ELR (P=0.039, P<0.001) elevations continued in the patients who developed infection and used multiple antibiotics. CRP and ESR values one day and 45 days after surgery were also found to be significantly associated with the development of infection and the use of multiple antibiotics. Conclusion: RDW, ELR and PLR parameters may be as important as CRP and ESR in predicting the development of infection and the number of antibiotics used in elderly patients undergoing rTKA.

Keywords

• Eosinophil-to-lymphocyte ratio
• platelet-to-lymphocyte ratio
• red cell distribution width
• revision total knee arthroplasty

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