| Popis: |
Background: Preoperatively accurate diagnosis of infected nonunion remains challenging. Here, we evaluated the diagnostic potential of novel biomarkers for infected nonunion. Methods: A cohort of 311 patients having surgery for suspected septic nonunion after open reduction and internal fixation were enrolled. Preoperatively analyzed clinical parameters included white blood cell (WBC), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), albumin, globulin, albumin-to-globulin ratio (AGR), plasma D-dimer, plasma fibrinogen, platelet count (PC), monocyte-lymphocyte ratio (MLR), neutrophil-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). Receiver operating characteristic (ROC) curves, sensitivity and specificity were utilized to compare the diagnostic potential of those biomarkers. Results: The WBC, CRP, ESR, NLR, MLR, PLR, PC, plasma D-dimer, plasma fibrinogen, and globulin levels in infected nonunion patients were significantly higher (p < 0.05) than aseptic patients. The albumin and AGR levels of infected nonunion group were significantly lower (p < 0.05). The ROC curve analysis showed the diagnostic accuracy of AGR and plasma fibrinogen was good. The combination of AGR with plasma fibrinogen had the highest area under the curve (AUC) (0.916). Sensitivity and specificity were 70.27% and 91.04% for AGR, and 67.57% and 84.08% for plasma fibrinogen, respectively. The combination of AGR with plasma fibrinogen showed a sensitivity of 86.49% and specificity of 92.54%. In patients with comorbidities, the diagnostic accuracy of the combination of AGR with plasma fibrinogen also performed well.Conclusion: AGR and plasma fibrinogen are promising biomarkers for improving the diagnosis of infected nonunion. The combination of AGR with plasma fibrinogen is a sensitive tool for screening infected nonunion. |
