The association between platelet indices and deep surgical site infection after open induction internal fixation for traumatic limb fractures

Abstract

ObjectivesDeep surgical site infection (DSSI) is one of the most serious complications after open induction internal fixation (ORIF) for traumatic limb fractures. In this study, we aimed to investigate the diagnostic role of platelet indices (platelet count [PLT], mean platelet volume [MPV], and platelet distribution width [PDW]) in DSSI.Patients and methodsData obtained between January 2011 and December 2017 in The Affiliated Drum Tower Hospital of Nanjing University Medical School from cases (n=29) with DSSI and fracture control subjects (n=29) matched for age, gender, and fracture type were analyzed. The white blood cell (WBC) count, neutrophil count, neutrophil percentage, and platelet indices from blood samples were compared between case and control groups. In addition, the cutoff value, sensitivity, and specificity were calculated by receiver-operating characteristic (ROC) curves.ResultsNo significant differences were detected in demographic features, the WBC count, neutrophil count, neutrophil percentage, and MPV values between two groups (P>0.05). The PLT values were significantly higher in the case group than in the control group (303.00±139.27 vs 196.10±59.61 [109/μL], P=0.001). The PDW values of the case and control groups were 11.77±2.71 and 13.19±2.39%, respectively, and were significantly lower in the case group (P=0.001). ROC curve analysis suggested a cutoff point for PLT as 215.50 (109/μL, larger values indicate pathology) for the diagnosis of DSSI with the sensitivity and specificity of 79.3 and 72.4%, respectively. For PDW, the cutoff point was 10.35% (smaller values indicate patients) for the diagnosis of DSSI with the sensitivity and specificity of 37.9 and 96.6%, respectively.ConclusionOur results suggest that PDW combined with PLT can be used as an important additional test for the diagnosis of DSSI after ORIF for traumatic limb fractures, thus reducing the cost and loss of time.

The Utility of Platelet Indices in Predicting Multiorgan Dysfunction in Scrub Typhus

“…Increased PDW was seen in ascitic fluid infection, vivax malaria, dengue, and septic shock [5,9,13,14]. PDW was reduced in deep-seated surgical site infection in orthopaedic patients and children with Gram-positive organism-related urinary tract infection [6,10]. In our study, there was no difference in PDW among patients with MODS and those without.…”

“…Platelet indices have been used in the diagnosis and prognosis of various inflammatory, infective, and malignant disorders [ 1 ]. Infections that have been studied include septic shock [ 5 ], urinary tract infection [ 6 ], tuberculosis [ 7 ], H. pylori [ 8 ], spontaneous bacterial peritonitis [ 9 ], surgical site infections [ 10 ], hepatitis [ 11 ], pneumonia [ 12 ], malaria [ 13 ], and dengue [ 14 ]. Platelet indices have not been previously studied in patients with scrub typhus, and hence we hypothesized whether these indices could predict multiorgan dysfunction syndrome in scrub typhus.…”

<p>Usefulness of serum D-dimer for preoperative diagnosis of infected nonunion after open reduction and internal fixation</p>

“…If not promptly diagnosed and managed, permanent loss of function, amputation, and even death may result 1. However, in the absence of any reliable method for diagnosing infection prior to nonunion surgery, surgeons cannot accurately discriminate between infected nonunion and aseptic nonunion 8,9. The Association for Osteosynthesis/Association for the Study of Internal Fixation (AO/ASIF) consensus definition of fracture-related infection includes four confirmatory criteria and six suggestive criteria 2.…”

Correlation between surgical site infection and time-dependent blood platelet count in immunocompromised patients after femoral neck fracture

“…In recent years, many studies have highlighted that PLTs are associated with certain infectious and inflammatory diseases. 20,21 Zhang et al 22 proposed that the PLT distribution width combined with the PLT count can be used as an important additional detection method for the diagnosis of deep SSI after traumatic limb fracture surgery, thereby reducing the cost and time loss. The present study showed a strong correlation between the PLT count and changes in the femoral neck fracture time in immunocompromised patients (R ¼ 0.99, P < 0.05).…”