Haematology panel biomarkers for humeral, femoral, and tibial diaphyseal fractures

Alexandru, Luchian; Hărăgus, Horia; Timar, Bogdan; Poenaru, Dan V.; Vlad, Daliborca

doi:10.1007/s00264-019-04305-1

Cited by 23 publications

(27 citation statements)

References 18 publications

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“…The ability to obtain prediction of outcome and adverse events from simple, readily available lab values is very tempting. Unlike specialized tests, standard blood count and routine biochemistry are performed for preoperative planning and general assessment [5,11,13,14].…”

Section: Resultsmentioning

confidence: 99%

Lymphocyte and Neutrophil to Lymphocyte Ratio do not Predict Mortality in Hip Fracture Patients

Pop¹,

Daliborca²,

Radu³

et al. 2019

Rev. Chim.

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Our study aimed to assess whether admission hemoglobin, lymphocyte count and neutrophil to lymphocyte ratio (N/R) can predict 1-year survival in patients with hip fractures. In the study, data from 54 patients with femoral neck fractures, 119 with trochanteric fractures respectively 24 with subtrochanteric fractures was analyzed. All the included patients were older than 55 years and were followed up to 2 years or until the decease occurred. The following parameters were recorded in patients with femoral neck, trochanteric respectively subtrochanteric fractures: average age: 76; 79.7 respectively 73.3 years; male to female ratio: 1:2.86; 1:3.1 respectively 1:2; average hemoglobin at admission: 13.13, 11.56 respectively 11.81; average lymphocyte count: 1.69; 1.7 respectively 1.75. At the logistic regression model built having the death as outcome and the lymphocytes respectively the N/L as predictors, we did notfound any significant associations in neither of the groups (p values of 0.837, 0.171 and 0.162 for lymphocyte and 0.920, 0.764 and 0.168 for N/L respectively). When age, gender and hemoglobin at admittance were accounted for, only for fractures of the trochanteric region age was predictive of survival with p[0.001. Our study showed no prediction for survival of hip fracture patients by using perioperatively collected total lymphocyte count and neutrophil to lymphocyte ratio.

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Section: Resultsmentioning

confidence: 99%

Lymphocyte and Neutrophil to Lymphocyte Ratio do not Predict Mortality in Hip Fracture Patients

Pop¹,

Daliborca²,

Radu³

et al. 2019

Rev. Chim.

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“…These biomarkers are a more likely indication of a low immune, systematic inflammation, and anemia status, but the stress effects from trauma cannot be ruled out [32]. In a study of humeral, femoral, and tibial diaphyseal fractures, authors observed significant changes of hematology panel biomarkers for any fracture location, compared to the controls [33]. In our study, if patients had multiple laboratory tests before when DVT was diagnosed, laboratory tests closest to the diagnostic time point were chosen for data analysis.…”

Section: Discussionmentioning

confidence: 99%

Incidence of deep venous thrombosis (DVT) of the lower extremity in patients undergoing surgeries for ankle fractures

Zixuan

Chen

et al. 2020

J Orthop Surg Res

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Objective: To investigate the incidence of postoperative deep venous thrombosis (DVP) in patients undergoing surgeries for ankle fractures and identify the associated risk factors. Methods: This was a retrospective study. A total of 1451 patients undergoing surgery of ankle fractures from January 2016 to June 2019 were included. The inpatient medical record system was inquired for data collection, including demographics, comorbidities, injury, and surgery-related data, and laboratory biomarkers. DVT of the lower extremity was diagnosed by routine Doppler examination. Univariate analyses and multivariate logistic regression analyses were used to identify the independent risk factors. Results: Among the 1451 patients, DVT was confirmed in 38 cases, indicating an incidence of 2.6%. DVT involved both the operated and non-operated limbs in 8 patients (21.1%). DVT involved superficial femoral vein in 4 cases (6.6%), deep femoral vein in 2 (3.3%), popliteal vein in 5 (8.2%), posterior tibial vein in 11 (18.0%), and peroneal vein in 39 (63.9%). The median interval between operation and diagnosis of DVT was 7 days. Six risk factors were identified to be independently associated with DVT, including age (10-year increase) (OR, 1.44), preoperative stay (delay of each day) (OR, 1.11), anesthesia (general vs regional) (OR, 3.51), lower hemoglobin level (OR, 2.02), total cholesterol > 5.2 mmol/L (OR, 3.20), and reduced lymphocyte count (OR, 3.16). Conclusion: These identified factors, although not easily modifiable, do help counsel patients about the risk of DVT and help individualized assessment of the risk factors and accordingly the risk stratification.

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“…In addition, inflammatory/immune response to trauma is the important contributing factor for development of DVT. Alexandru et al [11] evaluated the levels of hematology panel biomarkers in 148 patients with long-bone fractures, and found patients with fractures had significantly higher NLR level, compared to controls. However, in this study, we did not demonstrate the significant relationship between any of these inflammatory/immune indexes.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to external factors, there is increasing evidences that the internal factors, namely the systemic inflammation/immune response to traumatic fracture or major surgical trauma, played an important role in development of DVT. Alexandru et al [11] found the significant change of some inflammation/immune indexes (neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR)) after long-bone fracture. Moreover, researchers have identified the significant correlation of NLR, PLR, or monocyte to lymphocyte ratio (MLR) with acute DVT after major orthopaedic surgery [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Relationship between the Inflammation/immune Indexes and Deep Venous Thrombosis (DVT) following Tibial Plateau Fractures

Liu¹,

Chen²,

Li³

et al. 2020

Preprint

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Objective To determine the relationship between inflammation/immune-based indexes and preoperative DVT of lower extremities following tibial plateau fracturesMethods 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.

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Haematology panel biomarkers for humeral, femoral, and tibial diaphyseal fractures

Cited by 23 publications

References 18 publications

Lymphocyte and Neutrophil to Lymphocyte Ratio do not Predict Mortality in Hip Fracture Patients

Lymphocyte and Neutrophil to Lymphocyte Ratio do not Predict Mortality in Hip Fracture Patients

Incidence of deep venous thrombosis (DVT) of the lower extremity in patients undergoing surgeries for ankle fractures

Relationship between the Inflammation/immune Indexes and Deep Venous Thrombosis (DVT) following Tibial Plateau Fractures

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