The predictive role of platelet-to-lymphocyte ratio and systemic immune-inflammation index in young and middle-aged patients with tibial plateau fractures.
{"title":"The predictive role of platelet-to-lymphocyte ratio and systemic immune-inflammation index in young and middle-aged patients with tibial plateau fractures.","authors":"Shaowei Zhou, Xuemei Yang, Fang Hu, Xiaomeng Dong, Qingcheng Song, Shuhong Yang, Yingze Zhang","doi":"10.3389/fsurg.2025.1654222","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>There is suggestive evidence that the platelet-to-lymphocyte ratio (PLR) and systemic immune-inflammation index (SII) are related to the severity of fracture. The purpose of this study was to investigate the role of PLR and SII in predicting fracture severity in young and middle-aged patients with tibial plateau fractures (TPFs).</p><p><strong>Methods: </strong>A retrospective cohort study involving 229 patients with isolated TPFs was conducted between January 2015 and December 2019. Medical records of hospitalized patients were extracted from the electronic case system. Three experienced orthopedic surgeons classified the imaging data according to the Schatzker classification. All the patients were divided into two groups: group1 consisted of fractures of mild to moderate severity (Schatzker types I-IV), and group2 consisted of fractures of severe severity (Schatzker types V-VI). Platelet, neutrophil, and lymphocyte values at admission were obtained. The PLR = platelet/lymphocyte counts and the SII = platelet × neutrophil/lymphocyte counts were noted. Patients in groups 1 and 2 were statistically compared in terms of PLR and SII value on hospital admission.</p><p><strong>Results: </strong>There were significant differences in the blood PLR, SII, Na<sup>+</sup> and K<sup>+</sup> levels, and neutrophil count between the two groups. According to the receiver operating characteristic (ROC) curve, the cut-off of PLR and SII were 157.9 and 923.9, respectively. Our results showed that high PLR and SII were remarkably associated with the severity of TPFs. The sensitivity was 60% and the specificity was 86.9% when using the PLR ≥ 157.9 to predict the severity of the TPFs whereas the sensitivity was 63.3% and the specificity was 74.4% to predict the severity of TPFs at SII ≥ 923.9. In the multivariate analyses, the high preoperative PLR and SII were identified as independent predictors of severe TPFs.</p><p><strong>Conclusions: </strong>The PLR and SII are simple and economical biomarkers that require only routine blood tests with low associated costs. They can be calculated directly from platelet, neutrophil, and lymphocyte counts in standard blood routine reports, making them readily accessible and cost-effective tools to predict the severity of tibial plateau fractures.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1654222"},"PeriodicalIF":1.6000,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479416/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fsurg.2025.1654222","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: There is suggestive evidence that the platelet-to-lymphocyte ratio (PLR) and systemic immune-inflammation index (SII) are related to the severity of fracture. The purpose of this study was to investigate the role of PLR and SII in predicting fracture severity in young and middle-aged patients with tibial plateau fractures (TPFs).
Methods: A retrospective cohort study involving 229 patients with isolated TPFs was conducted between January 2015 and December 2019. Medical records of hospitalized patients were extracted from the electronic case system. Three experienced orthopedic surgeons classified the imaging data according to the Schatzker classification. All the patients were divided into two groups: group1 consisted of fractures of mild to moderate severity (Schatzker types I-IV), and group2 consisted of fractures of severe severity (Schatzker types V-VI). Platelet, neutrophil, and lymphocyte values at admission were obtained. The PLR = platelet/lymphocyte counts and the SII = platelet × neutrophil/lymphocyte counts were noted. Patients in groups 1 and 2 were statistically compared in terms of PLR and SII value on hospital admission.
Results: There were significant differences in the blood PLR, SII, Na+ and K+ levels, and neutrophil count between the two groups. According to the receiver operating characteristic (ROC) curve, the cut-off of PLR and SII were 157.9 and 923.9, respectively. Our results showed that high PLR and SII were remarkably associated with the severity of TPFs. The sensitivity was 60% and the specificity was 86.9% when using the PLR ≥ 157.9 to predict the severity of the TPFs whereas the sensitivity was 63.3% and the specificity was 74.4% to predict the severity of TPFs at SII ≥ 923.9. In the multivariate analyses, the high preoperative PLR and SII were identified as independent predictors of severe TPFs.
Conclusions: The PLR and SII are simple and economical biomarkers that require only routine blood tests with low associated costs. They can be calculated directly from platelet, neutrophil, and lymphocyte counts in standard blood routine reports, making them readily accessible and cost-effective tools to predict the severity of tibial plateau fractures.
期刊介绍:
Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles.
Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery.
Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact.
The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.