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Haematology panel biomarkers for humeral, femoral, and tibial diaphyseal fractures

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Abstract

Purpose

The neutrophil to lymphocyte ratio (NLR) is a simple predictor used in oncology and cardiology. We aimed to analyze the NLR profile of patients with diaphyseal fractures of the humerus, femur, and tibia.

Methods

We performed a cross-sectional, consecutive-case population-based study including 148 patients (41.9% men respectively 58.1% women) with humeral (23.0%), femoral (30.4%), and tibial (46.6%) diaphyseal fractures, admitted for surgical treatment in our level 1 trauma centre over two years.

Results

The differences in NLR between the studied subgroups were not significant (p = 0.067), the highest value being observed in patients with femoral fracture (5.6) in contrast to patients with humeral fracture (4). In the global cohort, there was a significantly positive correlation between NLR and PLR (platelet to lymphocyte ratio; Spearman’s r = 0.595; p < 0.001). The stratified subgroup analysis found significant association between NLR and duration of admission only for patients with femoral fracture (Spearman’s r = − 0.308; p < 0.001). When compared with controls, all three fracture types had significantly higher neutrophil numbers and NLR and lower thrombocyte numbers.

Conclusions

NLR are elevated in femur diaphyseal fractures compared with tibia and humerus, up to cut-off values with negative prediction of outcome in malignancy and cardiovascular patients. Increased NLR are predictive of longer hospital admissions for femur fractures.

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Acknowledgments

The authors acknowledge Dr. Andrei Gheorghitoiu.

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Authors and Affiliations

  1. Spitalul Clinic de Ortopedie Foișor, Bucharest, Romania

    Luchian Alexandru

  2. ‘Victor Babes’ University of Medicine and Pharmacy, Timisoara, Romania

    Luchian Alexandru

  3. Department of Orthopedics and Trauma, ‘Victor Babes’ University of Medicine and Pharmacy, Timisoara, Romania

    Horia Haragus, Bogdan Deleanu & Dan V. Poenaru

  4. Functional Sciences, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania

    Bogdan Timar

  5. Department of Pharmacology, ‘Victor Babes’ University of Medicine and Pharmacy, Timisoara, Romania

    Daliborca Cristina Vlad

Authors
  1. Luchian Alexandru
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  2. Horia Haragus
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  3. Bogdan Deleanu
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  4. Bogdan Timar
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  5. Dan V. Poenaru
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  6. Daliborca Cristina Vlad
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Correspondence to Horia Haragus.

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Alexandru, L., Haragus, H., Deleanu, B. et al. Haematology panel biomarkers for humeral, femoral, and tibial diaphyseal fractures. International Orthopaedics (SICOT) 43, 1567–1572 (2019). https://doi.org/10.1007/s00264-019-04305-1

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  • DOI: https://doi.org/10.1007/s00264-019-04305-1

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