Risk factors for postoperative infection in elderly patients with femoral neck fracture and predictive values of NLR,TLR2 and SDF-1
OBJECTIVE To explore the risk factors for postoperative infection in the elderly patients with femoral neck facture and analyze the predictive values of neutrophil to lymphocytes counts ratio(NLR),Toll-like receptor 2 and stromal cell derived factor-1(SDF-1).METHODS A total of 397 elderly patients with femoral neck fracture who were treated in Xinjiang People's Hospital from Jan 2019 to Jan 2023 were enrolled in the study,all of the pa-tients underwent surgical procedures and were divided into the infection group with 51 cases and the non-infection group with 346 cases according to the status of postoperative infection.The clinical data were collected from the patients,the risk factors for the postoperative infection and the expression levels of NLR,TLR2 and SDF-1 were observed,and the diagnostic values of the indexes were assessed by means of receiver operating characteristic(ROC)curves.RESULTS Of the 397 elderly patients with femoral neck fractures,51 had postoperative infection,with the incidence of postoperative infection 12.85％.The result of multivariate logistic analysis showed that com-plication with diabetes mellitus,long-term use of glucocorticoids,surgical procedures,postoperative drainage tube indwelling time and high expression of CRP were the risk factors for the postoperative infection in the elderly pa-tients with femoral neck fracture(OR=2.499,2.754,2.654,2.557,2.824,P＜0.05).The expression levels of NLR,TLR2 and SDF-1 of the infection group were higher than those of the non-infection group(P＜0.05).The AUC of the three indexes was 0.939 in diagnosis of postoperative infection in the elderly patients with femoral neck fracture,with the sensitivity 88.24％,the specificity 93.93％.CONCLUSION The incidence of postoperative infection is high among the elderly patients with femoral neck fracture.The postoperative infection in the elderly patients with femoral neck fracture is closely associated with the complication with diabetes mellitus,long-term use of glucocorticoids,operation duration more than 2 hours,postoperative drainage tube indwelling time more than 3 days and high expression of CRP.The patients with postoperative infection show high expression levels of NLR,TLR2 and SDF-1.The joint detection of the three indexes may raise the values in diagnosis of postoperative infection of the elderly patients with femoral neck fracture.
NETL
NSTL
万方数据
维普
