Risk factors of postoperative infection of complex tibial plateau fracture and diagnostic values of serum SDF-1 and sTREM-1
Objective To investigate the independent risk factors of postoperative infection in patients with complex tibi-al plateau fracture and the diagnostic values of serum stromal cell derived factor-1(SDF-1)and soluble myeloid cell trigger receptor-1(sTREM-1)in postoperative infection.Methods A total of 200 patients with tibial plateau frac-ture who were admitted to Luoyang Orthopedic-Traumatological Hospital of Henan Province(Henan Provincial Orthope-dic Hospital)from June 2020 to June 2023 were selected as the study targets,including 14 patients with postoperative infection.The incisional exudates of 14 patients with postoperative infection were cultured and the strains were identi-fied.The basic information and surgical information of patients were collected.logistic regression was utilized to probe the independent risk elements for postoperative infection.Receiver operating characteristic(ROC)curve was plotted to evaluate the diagnostic efficacies of SDF-1 and sTREM-1 in postoperative infection.Results A total of 29 pathogenic bacteria were identified in the cultures of 14 infected patients,mainly gram-positive bacteria,a total of 20 strains.Age,fracture type,length of hospital stay,whether diabetes mellitus was involved,operation time,and osteofascial compartment syndrome were all associated with postoperative infection of complex tibial plateau fracture(P＜0.05).Age ≥60 years old,open fracture,hospital stay ≥10 d,combined with diabetes mellitus,operation time ≥3 h and combined with osteofascial compartment syndrome were all independent risk elements for postoperative infection of com-plex tibial plateau fracture(OR＞1;P＜0.05).Compared with uninfected group,serum SDF-1 and sTREM-1 con-tent in infected group was prominently enhanced(P＜0.05).The area under the curve of serum SDF-1 and sTREM-1 combined diagnosis of postoperative infection was 0.888(P＜0.001),the sensitivity was 78.57％,and the specifici-ty was 94.62％,which was superior to the diagnostic efficacy of any single index.Conclusion In clinical practice,the above risk elements of postoperative infection should be prevented in advance to reduce the risk of postoperative infec-tion,promote postoperative recovery and improve the prognosis of patients.Serum SDF-1 and sTREM-1 combined de-tection had high diagnostic value for postoperative infection.
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