Association of inflammatory markers and surgical intervention with postoperative pneumonia in patients with femoral intertrochanteric fracture: A propensity score-matched cohort study

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2025-07-03 DOI:10.1016/j.jor.2025.06.025

Fang Li , Xiaojun Fu , Yingding Ruan , Juncheng Yu , Junhua Chen , Liming Xu , Jie Xiao

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引用次数: 0

Abstract

Background

This study was conducted to determine the value of inflammatory markers and surgical intervention for predicting the occurrence of postoperative pneumonia (POP) in patients undergoing proximal femoral nail antirotation (PFNA) surgery for femoral intertrochanteric fracture (FIF).

Methods

A retrospective cohort analysis was conducted on patients with FIF who underwent PFNA surgery at The First People's Hospital of Jiande from January 2021 to December 2024. Systematically documented variables included preoperative and postoperative inflammatory biomarker levels, demographic characteristics, surgical approach and duration, and postoperative outcomes. The prognostic capacity of inflammatory markers for predicting POP was evaluated through a propensity score-matched comparative analysis framework.

Results

Among 335 patients, 53 (15.8 %) had POP. After matching, 193 patients (POP group: n = 49; non-POP group: n = 144) were included in the analysis. The median (25th percentile, 75th percentile) postoperative systemic immune–inflammation index and neutrophil-to-lymphocyte ratio (NLR) were significantly higher in the POP group than in the non-POP group (1832.00 [1388.00, 3369.67] vs. 1261.76 [936.44, 1893.94], respectively P < 0.001, and 13.43 [10.85, 16.67] vs. 7.89 [5.32, 11.00], respectively, P < 0.001). Multivariate analysis showed that postoperative NLR was an independent predictor of POP (area under the receiver operating characteristic curve 0.8396, P < 0.001).

Conclusion

Postoperative NLR may predict POP among patients undergoing PFNA surgery for FIF. However, the clinical utility and optimal thresholds require validation in future prospective studies.

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股骨粗隆间骨折患者的炎症标志物和手术干预与术后肺炎的关联：一项倾向评分匹配的队列研究

本研究旨在确定炎症标志物和手术干预对股骨粗隆间骨折（FIF）患者行近端股骨钉反旋（PFNA）手术后肺炎（POP）发生的预测价值。方法回顾性队列分析2021年1月至2024年12月在建德市第一人民医院行PFNA手术的FIF患者。系统记录的变量包括术前和术后炎症生物标志物水平、人口统计学特征、手术方式和持续时间以及术后结果。通过倾向评分匹配的比较分析框架评估炎症标志物预测POP的预后能力。结果335例患者中，53例（15.8%）有POP。配对后193例患者(POP组：n = 49；非pop组：n = 144)纳入分析。POP组术后全身免疫炎症指数中位数（25百分位数，75百分位数）和中性粒细胞与淋巴细胞比值（NLR）显著高于非POP组(分别为1832.00[1388.00,3369.67]和1261.76 [936.44,1893.94],P <；0.001, 13.43 [10.85, 16.67] vs. 7.89 [5.32, 11.00], P <；0.001)。多因素分析显示，术后NLR是POP的独立预测因子(受试者工作特征曲线下面积0.8396,P <；0.001)。结论术后NLR可预测PFNA手术治疗FIF患者的POP。然而，临床应用和最佳阈值需要在未来的前瞻性研究中验证。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

期刊介绍： Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.