Correlation Analysis Of Asymptomatic Leukocyturia Before Total Hip Arthroplasty And Perioperative Inflammatory Markers

Objective: To explore the Correlation between patients with asymptomatic leukocyte urine(ASL)before total hip arthroplasty(THA)and perioperative inflammatory markers,whether it will increase the postoperative inflammation of the body,delay the postoperative recovery of the patient,or even cause periprosthetic joint infection.Provide basis and ideas for the perioperative individualized treatment of asymptomatic Leukocyturia patients.Methods: Collected patients who underwent total hip arthroplasty(THA)for the first time in our department from January 2016 to June 2019.The urine routine white blood cell count>13 was used as the limit,and they were divided into asymptomatic white blood cell urine group and normal group.Collect related inflammatory indicators during the perioperative period: white blood cell count(WBC),neutrophilic granulocyte percentage(NEUT%),c-reactive protein(CRP),erythrocyte sedimentation rate(ESR)and D-dimer(d-d).Compare the difference of inflammatory markers between the ASL group and the control group,and find the cut-off value of preoperative urine leukocyte count based on the severity of the inflammatory indexes.Results: A total of 782 patients’ medical records were collected.163 cases were excluded.Eventually,a total of 619 patients were included.The inflammatory markers of patients admitted to hospital for hip fracture were significantly higher than those of patients with other diseases(P<0.05).The patients were divided into fracture and non-fracture subgroups for discussion.There was no significant difference in perioperative inflammatory markers between the asymptomatic Leukocyturia of the fracture group and the normal group(P>0.05);there were significant differences between the two groups in the non-fracture group(P <0.05).Through ROC curve analysis,when the urine routine white blood cell count is more than 50,the chance of infection around the prosthesis will increase.Conclusion: Elderly women with poor nutritional status are prone to hip fractures,and are more likely to suffer from UTI,leading to increased perioperative systemic inflammatory response.Patients with ASL can cause abnormal increase in inflammatory indexes before and after hip replacement,increasing the possibility of postoperative infection,and when the preoperative urine white blood cell count is more than 50,there is a higher risk of periprosthetic joint infection,May require preoperative intervention of antibiotics and prolonged application time after surgery.