Neutrophil to lymphocyte ratio and fracture severity in young and middle-aged patients with tibial plateau fractures
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ORIGINAL PAPER
Neutrophil to lymphocyte ratio and fracture severity in young and middle-aged patients with tibial plateau fractures Zhongzheng Wang 1,2 & Siyu Tian 1,2 & Kuo Zhao 1,2 & Ruipeng Zhang 1,2 & Yingchao Yin 1,2 & Yanbin Zhu 1,2 & Zhiyong Hou 1,2 & Yingze Zhang 1,2 Received: 5 June 2020 / Accepted: 1 September 2020 # SICOT aisbl 2020
Abstract Purpose The neutrophil-to-lymphocyte ratio (NLR) has recently been found to be closely associated with the severity of trauma. This study aimed to analyze the correlation between the imaging severity of isolated tibial plateau fractures (TPFs) and the NLR in the blood. Methods A total of 223 patients with isolated TPFs were enrolled in this retrospective study over five years. The data at hospital admission were extracted from an electronic database. Schatzker classification was performed according to the imaging data by two experienced orthopaedic surgeons. All patients were divided into two groups: group 1 included patients with mild-tomoderate fractures (Schatzker types I–IV), and group 2 included patients with severe fractures (Schatzker types V–VI). The NLR levels at hospital admission were statistically compared between the two groups. Results The blood NLR, hemoglobin level, red blood cell count, neutrophil count, platelet count, time from injury to admission, total protein, and Na+ levels were significantly different among the two groups. According to the receiver operating characteristic (ROC) curve, the cutoff for the NLR was 5.8. ROC curve analysis showed that the sensitivity of an NLR ≥ 5.8 to predict severe TPFs was 53.4%, and the specificity was 70.7%. In the multivariate analysis, NLR ≥ 5.8 and haemoglobin < lower limit appeared to be independent predictors of severe TPFs. Conclusions Our study is the first to demonstrate that the NLR level appears to be a useful biomarker for predicting the severity of isolated TPFs in young and middle-aged adults. Keywords Neutrophil-to-lymphocyte ratio . Tibial plateau fractures . Fracture severity . Radiographic classification . Young and middle-aged adults
Introduction The tibial plateau is one of the most important load-bearing parts of the human body. Tibial plateau fractures (TPFs), a type of intra-articular fracture, represent approximately 1.2%
of all fractures. TPFs involve the proximal end of the tibia and seriously affect the alignment, stability, and movement of the knee [1–3]. Patients with TPFs have been found to show evidence of intraosseous trabecular disruption, medullary bone oedema, and haemorrhage. These usually indicate the severity
* Yingze Zhang [email protected]
Yingchao Yin [email protected]
Zhongzheng Wang [email protected]
Yanbin Zhu [email protected]
Siyu Tian [email protected]
Zhiyong Hou [email protected]
Kuo Zhao [email protected]
1
Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang 050051, Hebei, China
Ruipeng Zhang [email protected]
2
Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang 050051, C
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