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Platelet-hemoglobin ratio predicts amputation in patients with below-knee peripheral arterial disease

Nail Burak Ozbeyaz1, Gokhan Gokalp2, Engin Algul3

  • 1Department of Cardiology Clinic, Pursaklar State Hospital, 39 Cagatay Street, Pursaklar, Mimar Sinan District, 06145, Ankara, Turkey. drozbeyaz@gmail.com.

BMC Cardiovascular Disorders
|July 28, 2022
PubMed

Insights

The Platelet-Hemoglobin Ratio (PHR) can predict below-knee amputation (BKA) in peripheral arterial disease (PAD) patients. Higher PHR values indicate an increased risk for amputation, aiding in identifying high-risk individuals.

Area of Science:

  • Vascular Surgery
  • Hematology
  • Clinical Medicine

Background:

  • Peripheral arterial disease (PAD) is a significant cause of morbidity, often linked to atherosclerosis.
  • PAD shares risk factors with coronary artery disease, highlighting systemic vascular health concerns.
  • The Platelet-Hemoglobin Ratio (PHR) is a known predictor of mortality in atherosclerotic heart disease.

Purpose of the Study:

  • To investigate the association between the Platelet-Hemoglobin Ratio (PHR) and the risk of below-knee amputation (BKA) in PAD patients.
  • To evaluate PHR as a potential predictive biomarker for amputation in critical limb ischemia.
  • To determine if PHR can help identify PAD patients at higher risk for BKA.

Main Methods:

  • A single-center retrospective study included 235 PAD patients with below-knee critical extremity ischemia unsuitable for revascularization.
  • The Platelet-Hemoglobin Ratio (PHR) was calculated using the formula: platelet count/hemoglobin amount.
  • Multivariable regression analysis and ROC analysis were employed to assess risk factors and optimal cut-off values.

Main Results:

  • Patients who underwent amputation had significantly higher levels of white blood cell, neutrophil, platelet, creatinine, glucose, and PHR compared to the non-amputated group.
  • Hemoglobin levels were found to be lower in the amputated group.
  • Multivariable analysis identified age, albumin, and PHR as independent risk factors for amputation, with PHR showing an Odds Ratio of 1.872 (p=0.003).

Conclusions:

  • The Platelet-Hemoglobin Ratio (PHR) is a significant predictor of below-knee amputation (BKA) in patients with peripheral arterial disease.
  • A PHR cut-off value of 2.08 demonstrated optimal sensitivity (65.8%) and specificity (67.5%) for predicting amputation.
  • PHR can serve as a valuable tool for identifying PAD patients at high risk for BKA, potentially guiding clinical management.
Abstract

Keywords:
AmputationBelow-kneePeripheral arterial diseasePlatelet-hemoglobin ratio

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