Preoperative Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Other Predictors of Delayed Wound Healing After Anal Fistula Surgery: A Retrospective Study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Objective: To evaluate the association of preoperative neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) with delayed wound healing after anal fistula surgery and to develop a combined risk prediction model. Methods: Clinical data from 362 patients with anal fistula who underwent surgery between January 2022 and December 2024 were retrospectively analyzed. Patients were divided into a delayed healing group (>28 days, n=65) and a non-delayed healing group (≤28 days, n=297). Spearman correlation was used to assess the relationships between NLR, PLR, and healing time. LASSO regression was used for variable selection, and prespecified clinically important variables were forced into the final multivariable logistic regression model to identify independent risk factors. ROC curves were constructed to evaluate the predictive performance of NLR and PLR. Results: Preoperative NLR, PLR, and fasting blood glucose (FBG) were higher in the delayed healing group (all P<0.01), whereas albumin (Alb) was lower (P<0.001). NLR and PLR were positively correlated with healing time (r=0.199 and 0.242). Age (OR=1.044), wound area (OR=3.142), NLR (OR=2.369), PLR (OR=1.015), and FBG (OR=1.803) were independent risk factors, while Alb (OR=0.866) was protective (all P<0.05). The AUCs were 0.735 for NLR and 0.712 for PLR. The combined nomogram model achieved an AUC of 0.919 (95% CI: 0.880-0.957), with a bias-corrected AUC of 0.910 after bootstrap internal validation (1000 resamples), acceptable calibration (Hosmer-Lemeshow P = 0.057), and potential clinical utility in this cohort. Conclusion: Preoperative NLR and PLR were independently associated with delayed wound healing. The nomogram incorporating these and other factors showed moderate predictive value, was internally validated, and requires external validation.
DOI: 10.2147/jmdh.s629310
Authors: Ting Yang, Tao He, Aiping Tan, Mao Pi
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,836
OpenAlex ID: W7223385404