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Research article
Yingze Zhang
Key Laboratory of Biomechanics of Hebei Province
Corresponding Author
ORCiD: https://orcid.org/0000-0002-5419-7078
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Objective To determine the relationship between inflammation/immune-based indexes and preoperative DVT of lower extremities 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 cut-off 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 (16.3%) had a preoperative DVT. Among the biomarkers and indexes, only platelet and neutrophil were identified to be independently associated with DVT, and their predictive ability was stable regardless of open fracture with or without included. The other independent variables were elevated D-dimer level (>0.55mg/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
Inflammatory/immune index, Biomarkers, Deep venous thrombosis, Tibial plateau fractures, epidemiology
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On 19 Mar, 2020
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Received 14 Mar, 2020
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Received 14 Mar, 2020
Reviewer #4 agreed
On 06 Mar, 2020
Reviewer #3 agreed
On 05 Mar, 2020
Reviewer #2 agreed
On 01 Mar, 2020
Reviewers invited
Invitations sent on 27 Feb, 2020
Reviewer #1 agreed
On 27 Feb, 2020
Review #1 received
Received 27 Feb, 2020
Editor assigned
On 26 Feb, 2020
Editor invited
On 25 Feb, 2020
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On 21 Feb, 2020
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Subject Areas
Orthopedic Surgery
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A new preprint design is coming!
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This preprint is under consideration at Journal of Orthopaedic Surgery and Research. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Yingze Zhang
Key Laboratory of Biomechanics of Hebei Province
Corresponding Author
ORCiD: https://orcid.org/0000-0002-5419-7078
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Revision
Version 1
Posted 24 Feb, 2020
No community comments so far
Editorial decision: Major revision
On 19 Mar, 2020
Review #3 received
Received 14 Mar, 2020
Review #2 received
Received 14 Mar, 2020
Reviewer #4 agreed
On 06 Mar, 2020
Reviewer #3 agreed
On 05 Mar, 2020
Reviewer #2 agreed
On 01 Mar, 2020
Reviewers invited
Invitations sent on 27 Feb, 2020
Reviewer #1 agreed
On 27 Feb, 2020
Review #1 received
Received 27 Feb, 2020
Editor assigned
On 26 Feb, 2020
Editor invited
On 25 Feb, 2020
Submission checks complete
On 21 Feb, 2020
First submitted
On 19 Feb, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Orthopedic Surgery
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Objective To determine the relationship between inflammation/immune-based indexes and preoperative DVT of lower extremities 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 cut-off 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 (16.3%) had a preoperative DVT. Among the biomarkers and indexes, only platelet and neutrophil were identified to be independently associated with DVT, and their predictive ability was stable regardless of open fracture with or without included. The other independent variables were elevated D-dimer level (>0.55mg/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.
Figure 1
Figure 2
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