Application value of D-dimer in preoperative diagnosis of low toxic infectious nonunion

Abstract

To evaluate the value of D-dimer and common hematological indexes in the preoperative diagnosis of low toxicity infectious bone nonunion. Total of 116 cases of bone nonunion from June 2015 to January 2020 were analyzed retrospectively, including 91 males and 25 females;the age ranged from 18 to 65 years old with an average of(45.3±11.2) years old. According to the diagnostic criteria, 116 cases were divided into low toxicity infectious bone nonunion group(31 cases) and aseptic bone nonunion group(85 cases). D-dimer, total leukocyte count, C-reactive protein and erythrocyte sedimentation rate(ESR) were measured at admission, and the differences between two groups were compared. The diagnostic accuracy, sensitivity and specificity were analyzed through the subject working characteristic curve and the area under the curve. All patients were followed up for 12 to 24 months with an average of (11.5±4.3) months. D-dimer, total leukocyte count, C-reactive protein and ESR in low toxicity infectious bone nonunion group were higher than those in aseptic bone nonunion group(P<0.05);compared with other hematological indexes, the area under the curve of D-dimer was the highest, which is 0.826, and the best cut-off value of D-dimer was 1.57 g/L. The sensitivity and specificity of preoperative diagnosis of low toxicity infectious bone nonunion were 78.3% and 84.2%. The preoperative diagnostic value of D-dimer in low toxicity infectious bone nonunion is better than other inflammatory indexes. The combination of D-dimer and other inflammatory indexes is conducive to the early diagnosis of low toxicity infectious bone nonunion and the evaluation of the condition.