Abstract
BackgroundThe invasiveness of different surgical procedures is variable. The purpose of this study was to investigate the value of the postoperative neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as biomarkers in assessing the magnitude of surgery-related trauma in young and middle-aged patients with bicondylar tibial plateau fractures (TPFs).MethodsA total of 136 young and middle-aged patients with bicondylar TPFs who underwent surgical treatment between May 2016 and April 2020 were included. Details about demographic information, pre- and postoperative laboratory data, and surgical variables were obtained from the electronic database of our level I trauma center. According to the different surgery programs, all patients were divided into two groups: group 1, which represented minimally invasive reduction and internal fixation (MIRIF), and group 2, which represented open reduction and internal fixation (ORIF). Univariate and multivariate logistic regression and ROC curve analyses were used.ResultsThe operative time, intraoperative tourniquet use, intraoperative blood loss, length of incision, postoperative NLR, PLR, RBC and HCRP were significantly different between the two groups (P < 0.05). In the multivariate analysis, postoperative PLR ≥ 223.9, surgical incision > 19.0 cm and operative time > 130 min were closely related to severe surgery-related trauma. The ROC curve analysis indicated that postoperative PLR could predict severe surgery-related trauma with a specificity of 76.0 % and a sensitivity of 55.7 %.ConclusionsPostoperative PLR appears to be a useful biomarker that is closely associated with magnitude of surgery-related trauma in young and middle-aged patients with bicondylar TPFs.
Highlights
The invasiveness of different surgical procedures is variable
Previous studies suggested that traditional open reduction and internal fixation (ORIF) treatment for patients with bicondylar tibial plateau fractures (TPFs) represents a more invasive treatment with a higher risk of complications than minimally invasive reduction and internal fixation (MIRIF) [4, 5]
Study design and participants Data used in this study were extracted from an electronic database of our level I trauma center, in which a retrospective method was used to collect data on patients with bicondylar TPFs who underwent treatment with dual plating fixation between May 2016 and April 2020
Summary
The purpose of this study was to investigate the value of the postoperative neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as biomarkers in assessing the magnitude of surgery-related trauma in young and middle-aged patients with bicondylar tibial plateau fractures (TPFs). Several routine intra- and postoperative indicators, such as incision size, intraoperative blood loss and fluoroscopy frequency, operative time, postoperative complication rate, and healing time, have been successfully and widely used in assessing the invasiveness of a certain surgical procedure [8]. These parameters or indicators can only be roughly recorded or measured. Are there specific biomarkers that can more quickly and accurately reflect the invasiveness caused by surgery to patients? Which is worthy of our serious consideration
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