Relationship Between Serum sCD14 and sTREM-1 levels and Concurrent Infection in Patients with Traumatic Lower Extremi-ty Fracture After Surgery

LIU Guanlei; WU Yongdong; LI Fubin; LIU Wendong; GAO Shijie

doi:10.13730/j.issn.2097-2148.2025.05.008

Abstract：Objective To explore the relationship between the levels of serum soluble leukocyte differentiation antigen 14(sCD14)and soluble myeloid cells trigger receptor 1(sTREM-1)in patients with traumatic lower extremity fractures(TLEF)after surgery and concurrent infection.Methods A total of 104 TLEF patients admitted to author's hospital from January 2023 to January 2024 were selected as the study group,according to the presence or absence of postoperative infection,they were divided into infection group(n=67)and non-infection group(n=37);another 75 healthy individuals who underwent physical examinations at the author's hospital during the same period were selected as the control group.The levels of serum sCD14 and sTREM-1 of patients among 3 groups were compared;the predictive value of serum sCD14 and sTREM-1 levels for postoperative concurrent infection in TLEF patients was evaluated using the receiver operating characteristic(ROC)curve;the influencing factors of postoperative concurrent infection in TLEF patients were analyzed by multivariate Logistic regression.Results The levels of serum sCD14 and sTREM-1 of patients in the study group were higher than those in the control group(P＜0.05).The levels of serum sCD14 and sTREM-1 of patients in the infection group were higher than those in the non-infection group(P＜0.05).The area under the curve(AUC)of serum sCD14 and sTREM-1 for predicting postoperative concurrent infection in TLEF patients were 0.825(95％CI:0.782-0.887)and 0.741(95％CI:0.741-0.862)respectively,the AUC of the combined di-agnosis of the two was 0.914(95％CI:0.865-0.947).There were statistically significant differences in smoking history,diabetes mellitus history,postoperative drainage tube retention time and fracture type between infection group and non-infection group(P＜0.05).Multivariate Logistic regression analysis showed that sCD14≥ 92.85 μg/ml(OR=2.230,95％CI:1.636-3.039),sTREM-1 ≥ 2.03 ng/L(OR=3.235,95％CI:2.073-5.048),open fracture(OR=4.860,95％CI:1.029-22.950)and postoperative drainage tube retention time ≥ 3 d(OR=2.547,95％CI:2.102-3.087)were the influencing factors of postoperative concurrent infection in TLEF patients.Conclusion The levels of serum sCD14 and sTREM-1 in TLEF patients with postoperative concurrent infection are abnormally elevated,these levels have high sensitivity and specificity and are helpful for the clini-cal diagnosis of postoperative infection in TLEF patients.