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. 2020 Jul 2;15(1):241.
doi: 10.1186/s13018-020-01765-9.

Relationship between the inflammation/immune indexes and deep venous thrombosis (DVT) incidence rate following tibial plateau fractures

Dawei Liu  1 , Yanbin Zhu  2   3   4 , Wei Chen  2   3   4 , Junyong Li  2   3   4 , Kuo Zhao  2   3   4 , Junzhe Zhang  2   3   4 , Hongyu Meng  2   3   4 , Yingze Zhang  5   6   7   8
Affiliations

Relationship between the inflammation/immune indexes and deep venous thrombosis (DVT) incidence rate following tibial plateau fractures

Dawei Liu et al. J Orthop Surg Res. .

Abstract

Objective: To determine the relationship between inflammation/immune-based indexes and deep venous thrombosis (DVT) incidence rate following tibial plateau fractures METHODS: Retrospective analysis of a prospectively collected data on patients undergoing surgeries of tibial plateau fractures between October 2014 and December 2018 was performed. Duplex ultrasonography (DUS) was routinely used to screen for preoperative DVT of bilateral lower extremities. Data on biomarkers (neutrophil, lymphocyte, monocyte, and platelet counts) at admission were collected, based on which neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), monocyte/lymphocyte (MLR), and systemic immune-inflammation index (SII, neutrophil* platelet/lymphocyte) were calculated. Receiver operating characteristic (ROC) was used to determine the optimal cutoff value for each variable. Multivariate logistic regression analysis was used to evaluate the independent relationship of each biomarker or index with DVT, after adjustment for demographics, co-morbidities, and injury-related variables.

Results: Among 1179 patients included, 16.3% (192/1179) of them had a preoperative DVT. Four factors were identified to be significantly associated with DVT, including open fracture, increased D-dimer level. Among the biomarkers and indexes, only platelet and neutrophil were identified to be independently associated with DVT, and the significance remained after exclusion of open fracture. The other independent variables were elevated D-dimer level (> 0.55 mg/L), male gender, and hypertension in the sensitivity analysis with open fractures excluded.

Conclusion: These identified factors are conducive to the initial screening for patients at risk of DVT, individualized risk assessment, risk stratification, and accordingly, development of targeted prevention programs.

Keywords: Biomarkers; Deep venous thrombosis; Epidemiology; Inflammatory/immune index; Tibial plateau fractures.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
ROC to determine the optimal cutoff value for each biomarker or inflammatory/immune index, when in continuous variable
Fig. 2
Fig. 2
The predictive ability (sensitivity, specificity, and AUC) of each biomarker or inflammatory/immune index, when in dichotomous variable
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