# Platelet-to-lymphocyte ratio as a predictor of preoperative venous thrombosis in femoral fracture patients: a retrospective cohort study

## TL;DR

This study found that a higher platelet-to-lymphocyte ratio is linked to a greater risk of blood clots in patients with femoral fractures.

## Contribution

The study identifies PLR as a novel independent predictor of DVT in femoral fracture patients.

## Key findings

- PLR was an independent risk factor for DVT with an odds ratio of 1.74.
- PLR had modest predictive performance with an AUC of 0.60.
- Age, NLR, gender, smoking history, and multiple fractures were also significant risk factors.

## Abstract

The aim of this study was to investigate the relationship between the platelet-to-lymphocyte ratio (PLR) and the risk of lower extremity deep vein thrombosis (DVT) in patients with femoral fracture, and to evaluate the potential influence of other risk factors, including age, gender, smoking status, neutrophil-to-lymphocyte ratio (NLR), and multiple fractures of the lower extremities.

A retrospective study was conducted on 1,083 patients with femoral fractures treated at Meizhou People's Hospital between November 2017 and April 2024. DVT was diagnosed using Doppler ultrasound. Data on clinical features, including age, gender, body mass index, history of smoking, hypertension, diabetes mellitus, and multiple fractures of the lower extremities, were collected. Routine blood tests were performed at admission to calculate inflammatory indices, including PLR, NLR, and others. Logistic regression analysis was used to assess the independent association of these factors with DVT.

Among the 1,083 patients, 218 (20.1%) developed DVT. Logistic regression analysis identified that PLR (OR = 1.74, 95% CI: 1.16–2.62, P = 0.008), age (OR = 1.9, 95% CI: 1.21–3.30, P = 0.007), NLR (OR = 2.08, 95% CI:1.24–3.48, P = 0.005), gender (OR = 1.70, 95% CI: 1.17–2.49=, P = 0.005), history of smoking (OR = 2.19, 95% CI: 1.00–4.77, P = 0.05), and multiple fractures of the lower extremities (OR = 2.02, 95% CI: 1.32–3.11, P = 0.001) were independent risk factors for DVT.

PLR is an independent risk factor for lower extremity DVT in patients with femoral fracture, with a modest predictive performance (AUC = 0.60) that slightly outperforms age and NLR in this cohort. While these findings suggest PLR may have potential as a supplementary biomarker for DVT risk stratification, its clinical utility requires further validation in larger, multicenter studies.