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Background <p>Deep vein thrombosis (DVT) is a common and serious postoperative complication of tibial plateau fracture that significantly impacts patient prognosis, but its accurate risk prediction remains challenging. The utility of neutrophil-to-lymphocyte ratio (NLR) as a simple marker of inflammatory-immune status in thrombosis risk assessment is not clear, especially in the tibial plateau fracture population.</p> Methods <p>The study enrolled 1582 adult patients with tibial plateau fracture who underwent surgery from October 2019 to December 2023. Demographic characteristics, medical co-morbidities, surgical factors, and laboratory indicators were collected, with DVT within 14 days of surgery as the primary outcome. LASSO regression was used to screen key variables, and the dose-effect relationship between NLR and DVT was analyzed by 4-node restricted cubic spline (RCS) and the optimal cut-off value was determined, combined with multivariable logistic regression to assess the strength of the association, and sensitivity analyses to verify the robustness of the results.</p> Results <p>Baseline data showed that 54.4% were male with a mean age of 48.2 ± 12.5 years. Postoperative DVT occurred in 548 patients (34.64%). LASSO regression screened 16 variables suitable for inclusion in the model for adjustment. RCS revealed a significant nonlinear association (<i>P</i> &lt; 0.001), and the optimal cut-off value was determined to be 3.265. After PSM, high NLR remained an independent risk factor for DVT. Sensitivity analyses confirmed robustness.</p> Conclusion <p>NLR &gt; 3.265 independently predicts tibial plateau fracture postoperative DVT. Integrating NLR into risk models may aid personalized antithrombotic strategies, improving patient prognosis.</p>

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Preoperative neutrophil-to-lymphocyte ratio and postoperative deep vein thrombosis after tibial plateau fracture: a retrospective analysis of a prospectively collected cohort

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月22日

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  • Nuoman Han,
  • Guangzhao Hou,
  • Mengke Fan,
  • Rui Chen,
  • Zhenbang Yang,
  • Haoran Wang,
  • Haoyu Wang,
  • Wei Chen,
  • Hongzhi Lv

摘要

Background

Deep vein thrombosis (DVT) is a common and serious postoperative complication of tibial plateau fracture that significantly impacts patient prognosis, but its accurate risk prediction remains challenging. The utility of neutrophil-to-lymphocyte ratio (NLR) as a simple marker of inflammatory-immune status in thrombosis risk assessment is not clear, especially in the tibial plateau fracture population.

Methods

The study enrolled 1582 adult patients with tibial plateau fracture who underwent surgery from October 2019 to December 2023. Demographic characteristics, medical co-morbidities, surgical factors, and laboratory indicators were collected, with DVT within 14 days of surgery as the primary outcome. LASSO regression was used to screen key variables, and the dose-effect relationship between NLR and DVT was analyzed by 4-node restricted cubic spline (RCS) and the optimal cut-off value was determined, combined with multivariable logistic regression to assess the strength of the association, and sensitivity analyses to verify the robustness of the results.

Results

Baseline data showed that 54.4% were male with a mean age of 48.2 ± 12.5 years. Postoperative DVT occurred in 548 patients (34.64%). LASSO regression screened 16 variables suitable for inclusion in the model for adjustment. RCS revealed a significant nonlinear association (P < 0.001), and the optimal cut-off value was determined to be 3.265. After PSM, high NLR remained an independent risk factor for DVT. Sensitivity analyses confirmed robustness.

Conclusion

NLR > 3.265 independently predicts tibial plateau fracture postoperative DVT. Integrating NLR into risk models may aid personalized antithrombotic strategies, improving patient prognosis.