Diao Shuo, Li Jingqiao, Zhao Jianyong, Wang Dong, Wang Hanzhou, Xu Xiaopei, Zhou Junlin
Department of Orthopedic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
Department of Orthopedic Surgery, Hebei Jing-Xing Xian Hospital, Shijiazhuang, China.
Front Surg. 2022 Nov 2;9:1028542. doi: 10.3389/fsurg.2022.1028542. eCollection 2022.
This study aimed to investigate the association between new inflammatory indicators at admission and the occurrence of preoperative deep vein thrombosis (DVT) in patients with patella fractures.
A retrospective analysis of the medical records of patients aged 18 years or older who underwent surgical treatment for unilateral closed patella fractures at our hospital between August 2016 and August 2020. The incidence of preoperative DVT was detected by Duplex ultrasound (DUS). Partial blood routine and biochemical indexes were collected at admission, and the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) of inflammatory indexes were also calculated. ROC was used to analyze the cut-off value NLR, MLR, and PLR for predicting preoperative DVT, and univariate and multivariate analyses of the risk factors for preoperative DVT of patella fractures, and to verify whether other risk factors affecting the relationship between validation indexes and preoperative DVT.
A total of 500 patients were included, of which 39 patients (7.8%) developed preoperative DVT. After univariate and multivariate analysis, preoperative time (in each day delay), male (vs. female), D-dimer > 0.6 mg/L, total cholesterol (TC) > 5.6 mmol/L, and PLR > 189.8 were the risk factors for preoperative DVT in patients with patella fracture. Inflammation index PLR combined with the other four risk factors significantly improved the predictive efficacy of preoperative DVT compared with PLR ( = 0.009).
Inflammatory index PLR is a risk factor for preoperative DVT in patients with patella fracture, and the efficacy of PLR in predicting DVT can be significantly improved when other risk factors (male, D-dimer > 0.6 mg/L, TC > 5.6 mmol/L, and PLR > 189.8 of preoperative time in each day delay) are combined. These data are useful for the clinical identification of patients at high risk of preoperative DVT in patella fractures.
本研究旨在探讨髌骨骨折患者入院时新的炎症指标与术前深静脉血栓形成（DVT）发生之间的关联。
回顾性分析2016年8月至2020年8月期间在我院接受单侧闭合性髌骨骨折手术治疗的18岁及以上患者的病历。采用双功超声（DUS）检测术前DVT的发生率。入院时采集部分血常规和生化指标，并计算炎症指标的中性粒细胞与淋巴细胞比值（NLR）、单核细胞与淋巴细胞比值（MLR）和血小板与淋巴细胞比值（PLR）。采用ROC分析预测术前DVT的NLR、MLR和PLR的临界值，对髌骨骨折术前DVT的危险因素进行单因素和多因素分析，并验证其他影响验证指标与术前DVT关系的危险因素。
共纳入500例患者，其中39例（7.8%）发生术前DVT。经单因素和多因素分析，术前时间（每天延迟）、男性（与女性相比）、D-二聚体>0.6mg/L、总胆固醇（TC）>5.6mmol/L和PLR>189.8是髌骨骨折患者术前DVT的危险因素。炎症指标PLR与其他四个危险因素联合使用时，与PLR相比，显著提高了术前DVT的预测效能（=0.009）。
炎症指标PLR是髌骨骨折患者术前DVT的危险因素，当联合其他危险因素（男性、D-二聚体>0.6mg/L、TC>5.6mmol/L以及术前时间每天延迟时PLR>189.8）时，PLR预测DVT的效能可显著提高。这些数据有助于临床识别髌骨骨折术前DVT高危患者。
