Does the pre-operative neutrophil-lymphocyte ratio have a predictive value in detecting infection in type 3 open tibia diaphysis fractures?

BACKGROUND: This retrospective study was aimed to investigate whether the pre-operative neutrophil-lymphocyte (N/L) ratio has a predictive value in terms of evaluating the development of infection in patients with type 3 open fractures of the tibia diaphysis.
METHODS: A total of 72 patients with type 3 open tibia fractures who consulted to the emergency service at the Necmettin Er-bakan University Meram Faculty of Medicine, during the period between 2015 and 2020 were retrospectively examined. A total of 39 patients who underwent external fixator in the first treatment were included in the study. The information pertaining to the patients such as the patient demographic data, type of injury, wound cultures, and N/L rates during the pre-operative period were recorded. Patients were divided into two groups based on the presence of infection: Group 1 (12 patients) consisted of patients who had infec-tion, and Group 2 (27 patients) consisted of patients who had no infection.
RESULTS: 34 (87.2%) of the patients were male and 5 (12.8%) were women. The mean age of these patients was 43.18±18.67 (19–80). Infection was detected in 12 (30.8%) out of 39 patients. Of these patients, 9 (75%) were monomicrobial, and 3 (25%) were polymicrobial. The most common mechanism of the injury was gunshot injury in 16 (41%) of all patients. However, there was no sig-nificant difference between the groups in terms of mechanism of injury (p=0.445). When all patients were examined in terms of N/L rates and presence of infection, there was no significant difference between Group 1 and Group 2 (p=0.976).
CONCLUSION: Although N/L ratio of the blood in the pre-operative period has a predictive value for chronic diseases, we believe that it has no predictive value for detecting infection in patients with type 3 acute open tibia fractures.

Ameliyat öncesi nötrofl-lenfosit oranýnýn Tip 3 tibia diafiz açýk kýrýklarýnda enfeksiyon açýsýndan prediktif deðeri var mýdýr ?

AMAÇ: Bu geriye dönük çalýþmayda tibia diafiz tip 3 açýk kýrýklý hastalarda ameliyat öncesi dönemdeki nötrofl-lenfosit (N/L) oranýn enfeksiyon geliþiminin deðerlendirilmesi açýsýndan prediktif deðeri olup olmadýðýnýn araþtýrýlmasý amaçlanmýþtýr.
GEREÇ VE YÖNTEM: 2015–2020 yýllarý arasýnda Necmettin Erbakan Üniversitesi Meram Týp Fakültesi acil servisine baþvuran tibia tip 3 açýk kýrýklý 72 hasta geriye dönük olarak tarandý. Ýlk tedavisinde eksternal fiksatör yapýlan toplam 39 hasta çalýþmaya alýndý. Hastalarýn demografik verileri, yaralanma þekli, kültürlerinde üreme olup olmamasý ve ameliyat öncesi dönemdeki N/L oranlarý kayýt edildi. Hastalar enfeksiyon varlýðýna göre enfeksiyon olanlar: grup 1 (12 hasta), enfeksiyon olmayanlar: grup 2 (27 hasta) olarak iki gruba ayrýldý.
BULGULAR: Tüm hastalarýn 34’ü (%87.2) erkek beþi (%12.8) kadýndý. Bu hastalarýn yaþ ortalamasý 43.18±18.67 (19–80) idi. Toplam 39 hastadan 12’sinde (%30.8) enfeksiyon tespit edildi. Hastalarýn dokuzu (%75) monomikrobiyal üçü (%25) polimikrobiyaldi. Tüm hastalarýn 16’sýnda (%41), enfeksiyon olanlarýn altýsýnda (%50) ve enfeksiyon olmayanlarýn 10’unda (%37) en sýk yaralanma mekanizmasý ateþli silah yaralanmasýydý. Ancak gruplar arasýnda yaralanma mekanizmasý açýsýndan anlamlý bir fark bulunmadý (p=0.445). Tüm hastalar N/L oranlarý ile enfeksiyon varlýðý açýsýndan incelendiðinde grup 1 ve grup 2 arasýnda anlamlý fark tespit edilmedi (p=0.976).
TARTIÞMA: Ameliyat öncesi dönemdeki kanda hesaplanan N/L oranýnýn kronik hastalýklarda predikdif deðeri olmasýna karþýn akut tibia tip 3 açýk kýrýklý hastalarda enfeksiyon varlýðý açýsýndan prediktif deðerinin olmadýðý kanaatindeyiz.