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

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Ozbeyaz N. B., Gokalp G., Algul E., Sahan H. F., Aydinyilmaz F., Guliyev I., ...More

BMC Cardiovascular Disorders, vol.22, no.1, 2022 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 22 Issue: 1
  • Publication Date: 2022
  • Doi Number: 10.1186/s12872-022-02788-2
  • Journal Name: BMC Cardiovascular Disorders
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CAB Abstracts, CINAHL, EMBASE, MEDLINE, Veterinary Science Database, Directory of Open Access Journals
  • Keywords: Peripheral arterial disease, Below-knee, Amputation, Platelet-hemoglobin ratio
  • Ankara Yıldırım Beyazıt University Affiliated: No


Background: Peripheral arterial disease (PAD) causes significant morbidity today. Atherosclerosis is evident in the pathophysiological process in most patients, so PAD has similar risk factors as coronary artery disease. Platelet-Hemoglobin ratio (PHR) has been proven to predict mortality in atherosclerotic heart disease. We aimed to determine the relationship between PHR and below-knee amputation. Methods: The study is a single-center retrospective study. Platelet count/hemoglobin amount formula was used for PHR. Only PAD patients with below-knee critical extremity ischemia and unsuitable for revascularization were included in the study. Results: 235 patients were included in the study retrospectively. The mean age was 65.7 ± 9.9 years and 175(74.5%) of them were male. In the amputated group, white blood cell, neutrophil, platelet, creatinine, glucose, and PHR were higher (p =.031, p =.045, p =.011, p =.048 p =.018, p =.004, respectively). Only hemoglobin values were lower (p =.003). Multivariable regression analysis showed; age, albumin and PHR were determined as independent risk factors for amputation (Age; OR (95%CI): (1.094(1.040–1.152), p =.001) (Albumin; OR (95% CI): 1.950(1.623–1.799), p =.001) (PHR; OR (95% CI): 1.872(1.246–2.812), p =.003). Receiver operating characteristics analysis performed to determine the optimal cut-off value of PHR for amputation, the optimal value was found 2.08 (65.8% sensitivity, 67.5% specificity, p <.001). Conclusions: PHR was a good predictor for BKA. Using the PHR, it may be possible to identify high-risk patients for amputation.