Neutrophil-lymphocyte ratio predicts graft patency following lower limb revascularisation

Background: Graft failure is a significant problem following lower limb revascularisation. We hypothesised that the neutrophil-lymphocyte ratio (NLR), a simple and inexpensive index of systemic inflammation, predicts graft failure. Methods: Consecutive patients undergoing infra-inguinal bypass grafting were identified from a prospective database. All patients underwent routine graft surveillance using Duplex ultrasound. Potential predictors of graft failure (occlusion or ipsilateral amputation) were assessed in univariate and multivariate regression models. Results: Of 126 patients, 79 had patent grafts at 1 year. The only independent predictor of graft failure was the postoperative NLR. Conclusion: Post-operative NLR may be a simple, inexpensive means of focussing surveillance resources on patients at high-risk of graft failure. Its value needs to be confirmed in larger cohorts.