A Novel Biomarker to Screen for Malnutrition: Albumin/Fibrinogen Ratio Predicts Septic Failure and Acute Infection in Patients Who Underwent Revision Total Joint Arthroplasty

Maimaiti, Zulipikaer; Xu, Chi; Fu, Jun; Li, William Tianyu; Chai, Wei; Zhou, Yonggang; Chen, Jiying

doi:10.1016/j.arth.2021.04.027

Cited by 21 publications

(20 citation statements)

References 34 publications

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“…Maimaiti et al demonstrated that serum albumin may be an effective biomarker to assess nutritional status and predict acute infection after revision total joint arthroplasty. 14 Previous studies showed that hypoalbuminemia may increase the risks of primary and secondary infections. 15,16 In our study, we found that blood glucose was a significant predictor of infection in patients with DBS surgery.…”

Section: Discussionmentioning

confidence: 99%

Predictive nomogram for deep brain stimulation–related infections

Chen

Meng

et al. 2022

Neurosurgical Focus

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OBJECTIVE Infection is one of the important and frequent complications following implantable pulse generator and deep brain stimulation (DBS) electrode insertion. The goal of this study was to retrospectively evaluate and identify potential risk factors for DBS infections. METHODS From January 2015 to January 2021 in Qingdao municipal hospital (training cohort) and The First Affiliated Hospital of the University of Science and Technology of China (validation cohort), the authors enrolled patients with Parkinson disease who had undergone primary DBS placement or implantable pulse generator replacement. The cases were divided into infection or no-infection groups according to the 6-month follow-up. The authors used the logistic regression models to determine the association between the variables and DBS infection. Depending on the results of logistic regression, the authors established a nomogram. The calibration curves, receiver operating characteristic curve analysis, and decision curves were used to evaluate the reliability of the nomogram. RESULTS There were 191 cases enrolled in the no-infection group and 20 cases in the infection group in the training cohort. The univariate logistic regression showed that BMI, blood glucose, and albumin were all significant predictors of infection after DBS surgery (OR 0.832 [p = 0.009], OR 1.735 [p < 0.001], and OR 0.823 [p = 0.001], respectively). In the crude, adjust I, and adjust II models, the three variables stated above were all considered to be significant predictors of infection after DBS surgery. The calibration curves in both training and validation cohorts showed that the predicted outcome fitted well to the observed outcome (p > 0.05). The decision curves showed that the nomogram had more benefits than the "All or None" scheme. The areas under the curve were 0.93 and 0.83 in the training and validation cohorts, respectively. CONCLUSIONS The nomogram included BMI, blood glucose, and albumin, which were significant predictors of infection in patients with DBS surgery. The nomogram was reliable for clinical application.

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Section: Discussionmentioning

confidence: 99%

Predictive nomogram for deep brain stimulation–related infections

Chen

Meng

et al. 2022

Neurosurgical Focus

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“…Serum albumin and globulin have been demonstrated to be implicated in diverse infection and in ammation [24]. Although albumin is initially considered as a marker re ecting nutritional condition, it is negatively regulated by the acute phase reactant and the association between hypoalbuminemia and septic failure after joint replacement has been discovered [17,25]. Serum globulin mainly contains antibodies and in ammatory cytokines, and responds to in ammatory and infective reactions [26].…”

Section: Discussionmentioning

confidence: 99%

“…Three studies have also investigated the possibility of platelet and its associated markers in diagnosing PJI, demonstrating a poor to fair diagnostic value [14][15][16]. In addition, evidences have also correlated the level and composition of serum proteins such as albumin (ALB) and globulin (GLB) with septic failure after joint arthroplasty [17,18]. However, the number of the studies regarding these topics are still limited and further validation of the value of these markers for diagnosing PJI is needed.…”

Section: Introductionmentioning

confidence: 99%

Globulin and Albumin To Globulin Ratio Precisely Diagnose Periprosthetic Joint Infection and Determine The Timing of Second-Stage Reimplantation

Shang

Fei

et al. 2021

Preprint

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Background Periprosthetic joint infection (PJI) is one of the most challenging complication of total joint arthroplasty (TJI). An early and accurate diagnosis of PJI is associated with better treatment outcomes. However, whether the platelet-related markers and globulin-related markers can be used to assist the diagnosis of PJI remains elusive. Methods 206 patients underwent revision hip or knee arthroplasty in our institution were divided into two groups: 79 patients in PJI group and 127 patients in aseptic failure group. The levels of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), platelet-related markers including platelet count (PLT), mean platelet volume (MPV), plateletcrit (PCT) and PLT to MPV raito (PMR) and globulin-related markers, such as globulin, albumin to globulin ratio (AGR), and PLT to AGR ratio were compared. The diagnostic value was measured using area under the curve (AUC) after constructing receiver operating characteristic (ROC) curves. The potential of each marker for determining the timing of second-staged reimplantation was also evaluated. Results Significantly increased levels of ESR, CRP, PLT, PCT, PMR, GLB, and PLT to AGR ratio were identified in PJI group, while decreased levels of MPV and AGR were also found. The diagnostic values of all platelet-related markers and GLB were considered as fair, and good diagnostic values of AGR and PLT to AGR ratio were found, which were comparable to those of ESR and CRP. The levels of GLB and AGR can also be used to predict negative culture result and the timing of second-stage reimplantation. Conclusions Globulin and albumin to globulin ratio were found to have good diagnostic values for PJI, and they can precisely predict the culture results and persistent infection.

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“…In fact, serum albumin levels may also be in uenced by various factors such as liver diseases and changes of intravascular volume [39]. They may decrease as a result of in ammation due to acute or chronic diseases [40]. Therefore, serum albumin has been validated as a measurement of disease severity in the Acute Physiology and Chronic Health Evaluation scoring system [41].…”

Section: Analysis Of Correlated Factors Of Thyroid Hormonesmentioning

confidence: 99%

The prevalence, hospitalization outcomes and risk factors of euthyroid sick syndrome in patients with diabetic ketosis/ketoacidosis

Deng

et al. 2022

Preprint

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Background: To investigate the prevalence of euthyroid sick syndrome (ESS) and to evaluate the outcomes and risk factors associated with ESS among hospitalized patients with diabetic ketosis (DK) or diabetic ketoacidosis (DKA).Methods: Laboratory and clinical data of 396 adult hospitalized DK/DKA patients with or without ESS were collected and analyzed. Spearman linear analysis and multivariable logistic regression analyses were used to evaluate correlated factors of thyroid hormones and risk factors of ESS.Results: Most of the individuals were diagnosed with type 2 diabetes (359/396, 90.7%). The prevalence of ESS was 57.8% (229/396). Patients in ESS group were older and had a longer course of diabetes. Levels of thyroid hormones, serum lipids, and parameters reflecting acidosis were significantly decreased in ESS group. The proportion of patients with infection, acute renal injury and DKA was significantly higher in ESS group than in control group, accompanied by longer hospitalization stay and higher hospitalization costs. Free triiodothyronine was positively correlated with albumin, eGFR, parameters reflecting acidosis and lipid profiles (All P < 0.001), and was negatively correlated with age, onset age, 24-hour urine albumin, hsCRP and WBC count (All P < 0.001). Hypoalbuminemia, low level of carbon dioxide combining power, high level of HbA1c and WBC, and co-infection were shown to be risk factors for ESS (OR = 0.866, 0.933, 1.112, 1.146, 1.929, respectively; All P < 0.05).Conclusions: The prevalence of ESS was high in adult DK/DKA patients. Patients with ESS had inferior clinical and socioeconomic outcomes. Early recognition and management of patients with ESS may be necessary to improve outcome.

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A Novel Biomarker to Screen for Malnutrition: Albumin/Fibrinogen Ratio Predicts Septic Failure and Acute Infection in Patients Who Underwent Revision Total Joint Arthroplasty

Cited by 21 publications

References 34 publications

Predictive nomogram for deep brain stimulation–related infections

Predictive nomogram for deep brain stimulation–related infections

Globulin and Albumin To Globulin Ratio Precisely Diagnose Periprosthetic Joint Infection and Determine The Timing of Second-Stage Reimplantation

The prevalence, hospitalization outcomes and risk factors of euthyroid sick syndrome in patients with diabetic ketosis/ketoacidosis

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