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Investigating of serum inflammatory factors and synovial fluid neutrophil to lymphocyte ratio and clinical outcomes in patients with septic arthritis
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Fahimeh Rohollah    , Maedeh Najafizadeh * , Ladan Rahkhodapour , Mohammad Javad Azadchehr |
| , dr.maedeh.najafizadeh@gmail.com |
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Abstract: (4 Views) |
Introduction: Septic arthritis is a serious clinical emergency that, if diagnosed or treated late, can lead to permanent joint disability or even death. The use of inflammatory markers such as ,Erythrocyte Sedimentation Rate, ,C-Reactive Protein, and Neutrophil-to-Lymphocyte Ratio in blood and synovial fluid may facilitate earlier diagnosis and help predict clinical outcomes.
Materials and Methods: This retrospective descriptive-analytical study was conducted on 146 patients with septic arthritis admitted to Shahid Beheshti Hospital, Kashan, between 2020 and 2024. Demographic data, laboratory findings (CRP, ESR, and NLR in blood and synovial fluid), and treatment outcomes (recovery, surgical interventions, joint replacement, arthrodesis, amputation, or death) were extracted from patient records and After recording the data and outcomes, the extracted information was entered into a researcher-made checklist. The data were first recorded manually and then entered into Excel software and transferred to SPSS for statistical analysis.
Results: The mean age of patients was 12.97 ± 54.16 years, and 65.1% were male. Trauma (66.4%) was the most common cause, and the knee (54.8%) was the most frequently affected joint. Diabetes (30.8%) and hypertension (30.1%) were the most prevalent comorbidities. Laboratory analyses revealed abnormal CRP in 84.9%, abnormal ESR in 80.8%, and abnormal synovial NLR in 80.8% of patients. Surgical intervention was required in 68.5% of cases. Comparisons between groups showed that mean WBC (p = 0.020) and synovial NLR (p = 0.024) were significantly higher in patients requiring surgery, and synovial NLR was significantly higher in those requiring joint replacement (p = 0.011). The overall mortality rate was 2.7%.
Conclusion: The findings suggest that inflammatory markers, particularly synovial fluid NLR, may play a key role in predicting the need for surgical intervention and disease severity. Incorporating these biomarkers alongside clinical assessments may improve treatment decision-making. Further multicenter studies with larger sample sizes are recommended to validate these results.
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| Keywords: Septic arthritis, CRP, ESR, NLR, inflammatory markers, clinical outcomes, synovial fluid. |
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Type of Study: Research |
Subject:
medicine, paraclinic
Received: 2025/11/1 | Revised: 2025/12/9 | Accepted: 2025/12/9
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