Predictive Value of Lymphocyte-Based Inflammation Index for Clinical Outcome in Patients With Lower Extremity Arteriosclerosis Obliterans: A Systematic Review and Meta-Analysis

This study evaluated the association of lymphocyte-based composite inflammatory indices with lower extremity arteriosclerosis obliterans (LEASO). PubMed, Embase, Cochrane Library, and Web of Science were searched up to March 12, 2024. The endpoints included mortality, amputation, restenosis, major adverse limb events, and amputation-free survival (AFS). In total, 33 studies were included (n = 12 386). For categorical variables, the results showed that high neutrophil-to-lymphocyte ratio (NLR) was closely associated with mortality, restenosis, amputation, and AFS (OR: 1.31; 95% CI: 1.17-1.47, 1.46; 95% CI: 1.15-1.84, 1.83; 95% CI: 1.48-2.27 and 2.29; 95% CI: 1.75-3.00, respectively; all <i>P</i> < .00001). High platelet-to-lymphocyte ratio (PLR) was not significantly associated with mortality, restenosis, and amputation. High systemic immune-inflammation index (SII) was not significantly correlated with restenosis. For continuous variables, NLR and PLR were correlated with amputation, while the relationship between lymphocyte to monocyte ratio (LMR) and amputation was relatively weak. Subgroup analysis revealed that preoperative NLR testing was more valuable in predicting mortality and restenosis than postoperative testing. High NLR is significantly associated with amputation, restenosis, and AFS of LEASO patients. Furthermore, preoperative NLR is more accurate in predicting LEASO prognosis. PLR, LMR, and SII are not insignificant correlated with LEASO prognosis.