Neutrophil-to-Hemoglobin Ratio and Monocyte-to-Hemoglobin Ratio Predict Prolonged Length of Stay in Patients Undergoing Surgery for Pelvic or Acetabular Fractures

This study evaluated the neutrophil-to-hemoglobin ratio (NHR) and monocyte-to-hemoglobin ratio (MHR) as predictors of prolonged hospital stay in patients undergoing surgery for pelvic or acetabular fractures. We retrospectively reviewed records of patients aged ≥ 18 years who underwent open reduction and internal fixation (ORIF). NHR and MHR were calculated from blood samples at admission and 24 hours postoperatively. Prolonged hospital length of stay (LOS) was defined as ≥ 25 days (75th percentile). Optimal cutoffs were determined by ROC curve analysis. Multivariable logistic regression identified associations between clinical variables and prolonged LOS. Among 172 patients (mean age 44.5), postoperative NHR > 0.46 and MHR > 0.02 were independently associated with prolonged LOS in patients with acetabular fractures (aOR = 5.90 and 5.42, respectively). No significant associations were found in pelvic fractures. Elevated postoperative NHR and MHR are strongly associated with prolonged LOS in patients with acetabular fractures and may assist in perioperative risk stratification and clinical decision-making.

本研究评估了中性粒细胞与血红蛋白比值（NHR）及单核细胞与血红蛋白比值（MHR）作为骨盆或髋臼骨折手术患者住院时间延长的预测因子的价值。我们回顾性分析了年龄≥18岁、接受切开复位内固定术（ORIF）的患者的临床病历资料。NHR与MHR分别于入院时及术后24小时通过血液样本计算得到。将住院时长（LOS）≥25天（即第75百分位数）定义为住院时间延长。通过ROC曲线分析确定最优截断值。采用多因素logistic回归分析临床变量与住院时间延长之间的关联。本研究共纳入172例患者（平均年龄44.5岁），其中髋臼骨折患者中，术后NHR＞0.46及MHR＞0.02与住院时间延长独立相关（校正后比值比[aOR]分别为5.90和5.42）；骨盆骨折患者未观察到显著关联。术后升高的NHR与MHR与髋臼骨折患者的住院时间延长显著相关，或可辅助围手术期风险分层及临床决策制定。