Relationship of hematological and biochemical parameters with WOMAC index to severity of osteoarthritis: A retrospective study

Aim: Our aim was to investigate whether any hematologic changes that could be detected easily in whole blood counts together with the Western Ontario and McMaster Universities Osteoarthritis score (WOMAC) had diagnostic value for predicting knee osteoarthritis severity. Methods: A retrospective study including a total of 208 knee osteoarthritis patients (112 patients early and 106 patients late osteoarthritis) was carried out. Cut-off values for age, C-reactive protein, neutrophil leukocyte ratio and WOMAC index for osteoarthritis were calculated. A multivariate logistic regression model was used to identify the independent factors of late osteoarthritis. Results: Compared with late osteoarthritis with early osteoarthritis, late osteoarthritis had significantly higher C-reactive protein, neutrophil leukocyte ratio and WOMAC index (p=0.019, p=0.028 and p=0.001, respectively). Area Under Curve was found to be 0.922, 0.533, 0.558 and 0.824 for age, C-reactive protein, neutrophil leukocyte ratio and WOMAC index, respectively. Multilogistic regression analysis was performed with C-reactive protein, neutrophil leukocyte ratio and WOMAC index to determine independent risk factors associated with late osteoarthritis. Odds ratios for neutrophil lymphocyte ratio, C-reactive protein and WOMAC index were found to be 1.317 (95% CI = 1.030-1.682, p = 0.034), 1.055 (95% CI = 1.004-1.108, p = 0.028) and 1.078 (95% CI = 1.056-1.100, p=0.001), respectively. Age, neutrophil leukocyte ratio, C-reactive protein and WOMAC index were statistically significant in predicting late osteoarthritis. Conclusions: Our study suggests that increased neutrophil leukocyte ratio, C-reactive protein and WOMAC index are associated with independent risk factors for late osteoarthritis