Korelasi Rasio Neutrofil Limfosit Dengan Tingkat Keparahan pada Pasien Ulkus Diabetes Melitus tipe 2 di RSUD Dr. Moewardi Surakarta

Prima Budi Prayogi¹, Prima Kharisma Hayuningrat², Suharto Wijanarko³, Hari Wujoso ⁴

¹General Surgery Resident, Faculty of Medicine, Universitas Sebelas Maret/Dr. Moewardi General Hospital, Surakarta, Indonesia

²Department of Cardiothoracic surgery, Universitas Sebelas Maret/Dr. Moewardi General Hospital, Surakarta, Indonesia

³Department of Urology, Universitas Sebelas Maret/Dr. Moewardi General Hospital, Surakarta, Indonesia

³ Department of Forensic Medicine and Medicolegal, Universitas Sebelas Maret/Dr. Moewardi General Hospital, Surakarta, Indonesia

Abstrack

Background: Diabetic foot ulcer (DFU) in type 2 diabetes mellitus (T2DM) is a severe complication associated with high morbidity and mortality. Systemic inflammation is suspected to play a role in the severity of T2DM ulcers. The neutrophil-to-lymphocyte ratio (NLR), as a potential marker of systemic inflammation, is considered useful for assessing ulcer severity.

Objective: To evaluate the correlation between NLR and the severity of diabetic foot ulcers in hospitalized patients at Dr. Moewardi General Hospital, Surakarta.

Methods: This was a quantitative analytic study with a cross-sectional approach using secondary data from medical records of hospitalized T2DM patients with foot ulcers between January 2022 and December 2023. A total of 60 patients who met the inclusion criteria were analyzed. NLR values were obtained from complete blood counts with differential leukocyte counts, and ulcer severity was classified using the Meggit-Wagner system. Data were analyzed using Spearman’s rank correlation test.

Results: The mean NLR was 9.80 ± 11.14. The most frequent ulcer severity grades were grade 4 (35.0%) and grade 3 (30.0%). Spearman’s analysis showed a significant positive correlation between NLR and ulcer severity (r = 0.412; p = 0.001).

Conclusion: There is a significant positive correlation between NLR values and the severity of diabetic foot ulcers in patients with T2DM. NLR may be considered a simple and cost-effective predictive marker for assessing ulcer severity, particularly in resource-limited healthcare settings.

Keywords: Type 2 diabetes mellitus, neutrophil-to-lymphocyte ratio, ulcer severity, inflammation, Meggit-Wagner classification.