The predictive role of platelet-to-lymphocyte ratio and systemic immune-inflammation index in young and middle-aged patients with tibial plateau fractures.

IF 1.6 4区 医学 Q2 SURGERY
Frontiers in Surgery Pub Date : 2025-09-16 eCollection Date: 2025-01-01 DOI:10.3389/fsurg.2025.1654222
Shaowei Zhou, Xuemei Yang, Fang Hu, Xiaomeng Dong, Qingcheng Song, Shuhong Yang, Yingze Zhang
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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.

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血小板与淋巴细胞比值及全身免疫炎症指数在中青年胫骨平台骨折患者中的预测作用。
背景:有证据表明,血小板与淋巴细胞比值(PLR)和全身免疫炎症指数(SII)与骨折的严重程度有关。本研究的目的是探讨PLR和SII在预测中青年胫骨平台骨折(TPFs)患者骨折严重程度中的作用。方法:2015年1月至2019年12月,对229例孤立性tpf患者进行回顾性队列研究。从电子病例系统中提取住院患者的病历。三位经验丰富的骨科医生根据Schatzker分类对影像资料进行分类。所有患者分为两组:组1为轻至中度骨折(Schatzker型I-IV),组2为重度骨折(Schatzker型V-VI)。获得入院时的血小板、中性粒细胞和淋巴细胞值。记录PLR =血小板/淋巴细胞计数和SII =血小板×中性粒细胞/淋巴细胞计数。对1组和2组患者入院时PLR和SII值进行统计学比较。结果:两组患者血液PLR、SII、Na+、K+水平及中性粒细胞计数差异均有统计学意义。根据受试者工作特征(ROC)曲线,PLR和SII的截止值分别为157.9和923.9。我们的研究结果表明,高PLR和SII与tpf的严重程度显著相关。当PLR≥157.9预测TPFs严重程度时,敏感性为60%,特异性为86.9%,而SII≥923.9预测TPFs严重程度的敏感性为63.3%,特异性为74.4%。在多变量分析中,高术前PLR和SII被确定为严重tpf的独立预测因子。结论:PLR和SII是简单、经济的生物标志物,仅需常规血液检查,相关费用低。它们可以直接从标准血常规报告中的血小板、中性粒细胞和淋巴细胞计数中计算出来,使它们易于获得且具有成本效益的工具来预测胫骨平台骨折的严重程度。
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来源期刊
Frontiers in Surgery
Frontiers in Surgery Medicine-Surgery
CiteScore
1.90
自引率
11.10%
发文量
1872
审稿时长
12 weeks
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.
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