Diagnostic Value of ESR,CRP and COX-2 for Postoperative Infection in Orthopaedic Trauma and Correlation with SIRS

Yu Qingzhou; Wang Yang; Lei Tao; Huang He; Shao Fangyuan; Fang Chao; Deng Miao

Abstract：Objective To explore the diagnostic value of serum erythrocyte sedimentation rate(ESR),C-reactive protein(CRP)and cyclocyception-2(COX-2)indexes in postoperative infection of orthopaedic trauma patients and their correlation with systemic inflammatory response syndrome(SIRS)score.Methods Ninety-eight patients with open orthopaedic injuries who were treated and treated in the orthopaedic department of Chongqing General Hospital of the Chinese People's Armed Police Force from July 2019 to July 2022 were selected as the study objects,and were divided into infected group and uninfected group according to whether the patients were infected after surgery.There were 43 cases in the infected group,including 25 males and 18 females.The average age was(56.19±4.33)years,ranging from 21 to 65 years.There were 55 cases in the uninfected group,including 29 males and 26 females.The average age was(56.37±4.49)years,ranging from 21 to 66 years.Serum ESR,CRP and COX-2 levels were detected by enzyme linked immuno sorbent assay(ELISA).The patients underwent routine blood tests and vital signs monitoring,and SIRS score was calculated;The levels of ESR,CRP and COX-2 in the infected and uninfected groups were compared.The diagnostic value of serum ESR,CRP and COX-2 in postoperative infection of orthopaedic trauma patients was analyzed.The difference of SIRS scores before and after surgery was compared between infected and uninfected orthopaedic trauma groups.The correlation between ESR,CRP and COX-2 and SIRS score was analyzed by Pearson.Results After operation,the levels of ESR,CRP and COX-2 increased in both groups,and the expression of infected group was significantly higher than that of uninfected group(P＜0.05).The AUC under the ROC curve of ESR,CRP and COX-2 combined test was 0.899 in the diagnostic evaluation of patients with postoperative infection in orthopaedics,which had high specificity and sensitivity,and was significantly higher than that of ESR and CRP alone,and the combined diagnosis was highly consistent in patients with postoperative infection in orthopaedics(P＜0.05).3 days after operation,SIRS scores of both groups increased,and the score of infected group was significantly higher than that of non-infected group(P＜0.05).Pearson analysis of the correlation between ESR,CRP and COX-2 and SIRS score in postoperative infection patients showed significant positive correlation with SIRS score(all P＜0.001).Conclusion Serum ESR,CRP and COX-2 are highly expressed in infected patients after orthopaedic surgery.Combined detection is of high value in the diagnosis of infection.In addition,serum ESR,CRP and COX-2 showed a significant positive correlation with SIRS score,indicating that timely detection of indicators could be carried out to reduce the incidence of postoperative infection.