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

Abstract

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.