Diagnostic value of platelet indices in infected nonunion: a retrospective study

Wang, Zhen; Mao, Haijun; Qiu, Xusheng; Chen, Yixin; Xu, Guangyue

doi:10.1186/s13018-022-03096-3

Cited by 6 publications

(6 citation statements)

References 37 publications

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“…The distribution of pathogens did not differ drastically in our cohort compared to previous reports [16][17][18][19][20] . Staphylococci, both S. aureus and CoNS, are the most common causative bacteria in mono-and polymicrobial infections.…”

Section: Pathogenscontrasting

confidence: 70%

“…However, in polymicrobial FRI in our cohort other Gram-positive bacteria (e.g., Cutibacterium spp., streptococci and enterococci) were not uncommon. The lower number of Gram-negative aerobe and anaerobe bacteria could be linked to the low number of open fractures in our cohort [16][17][18][19][20] . Depending on the fracture site, there was also a difference in the distribution of pathogens, especially for the proximal humerus FRI, where Cutibacterium spp.…”

Section: Pathogensmentioning

confidence: 84%

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Analysis of fracture-related infections from Swedish insurance claims between 2011 and 2021

Khalili,

Tevell,

Fischer

et al. 2023

Sci Rep

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Fracture-related infections (FRI) pose a serious complication with an incidence of 1–2%. This study aimed to analyze compensation claims submitted to The Swedish National Patient Insurance Company (LÖF) because of FRI after closed/open reduction and internal fixation (C/ORIF) in the four most common fracture sites (proximal humerus, distal radius, hip, ankle). Patients registered in the LÖF database with a suspected FRI between 2011 and 2021 were identified by matching International Classification of Diseases and procedural codes indicative of a combination of fractures to the proximal humerus, distal radius, hip and ankle, C/ORIF and infection. Medical records were reviewed for fracture sites, pathogens and complications. Data from the Swedish Fracture Register (SFR) were extracted to estimate the proportion of reported claims to the presumed number of FRI. Of 122 FRI identified in the LÖF database, 34 were after C/ORIF in the proximal humerus, 12 in the distal radius, 28 in the hip and 48 in the ankle. LÖF compensated 111 patients (91%). Median time from C/ORIF to an FRI was 3 weeks (interquartile range 2–6), and 95% of all FRI occurred within 1 year after C/ORIF. Staphylococcus aureus was the most common pathogen in patients with a distal radius, hip and ankle FRI. In contrast, Cutibacterium spp. were the most common aetiology in FRI of the proximal humerus. The total number of fractures treated with C/ORIF in the four fracture sites registered in the SFR during 2021 was 18,711. Most of the FRI patients were diagnosed within the first year after C/ORIF, and 91% of the patients received compensation. Given an expected FRI incidence of 1–2%, our estimates with extrapolated data from the SFR indicate that < 10% of affected patients applied for compensation.

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Section: Pathogenscontrasting

confidence: 70%

Section: Pathogensmentioning

confidence: 84%

Analysis of fracture-related infections from Swedish insurance claims between 2011 and 2021

Khalili,

Tevell,

Fischer

et al. 2023

Sci Rep

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“…A study by Wang et al revealed that PVR is a valuable biomarker for the early diagnosis of infectious bone nonunion. 29 Recent investigations have also shown the potential of the PLR and PVR in aiding PJI diagnosis. 30,31 In a retrospective analysis of 464 patients who underwent revision surgery (191 of whom had PJI), Klemt et al demonstrated that the PLR and PVR were valuable diagnostic tools, with an AUC of 0.86 for both indicators.…”

Section: Discussionmentioning

confidence: 99%

Different Biomarker Ratios in Peripheral Blood have Limited Value in Diagnosing Periprosthetic Joint Infection after Artificial Joint Replacement：A Single-Center, Retrospective Study

Deng,

Wang,

Yang

et al. 2024

Preprint

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Background: Periprosthetic joint infection (PJI) is a severe complication that can occur after artificial joint replacement (AJR). The timely and accurate diagnosis of PJI is the key to treatment. This study investigated the diagnostic value of platelet to lymphocyte ratio (PLR), platelet count to mean platelet volume ratio (PVR), neutrophil to lymphocyte ratio (NLR) and monocyte to lymphocyte ratio (MLR) in PJI after total knee arthroplasty (TKA) and total hip arthroplasty (THA). Methods: Our team conducted a retrospective analysis of 187 patients who received knee or hip joint revision surgeries at the Department of Joint Surgery of Zhengzhou Orthopaedic Hospital between June 2015 and June 2020. The 168 patients were eventually included based on the inclusion and exclusion criteria. According to the diagnostic criteria of the Musculoskeletal Infection Society (MSIS), 58 patients were in the PJI group, and 110 patients were in the aseptic loosening (AL) group. We recorded and compared the preoperative peripheral blood white blood cell (WBC) count, platelet count (PLT), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), PLR, PVR, NLR, and MLR in both groups. The diagnostic performance of the PLR, PVR, NLR, and MLR individually and in combination with the ESR and CRP for PJI diagnosis was evaluated by receiver operating characteristic (ROC) curves, and the sensitivity, specificity, positive predictive value, and negative predictive value were calculated. Results: Compared to those in the AL group, the mean WBC, PLT, ESR, CRP, PLR, PVR, NLR, and MLR in the peripheral blood of the PJI group were significantly greater (P < 0.05). The analysis of the ROC curve revealed that the ESR, CRP, PLR, PVR, NLR, and MLR in peripheral blood had moderate effectiveness in diagnosing PJI, with area under the curve (AUC) values of 0.760 (95% CI: 0.688-0.823), 0.758 (95% CI: 0.687-0.821), 0.714 (95% CI: 0.639-0.781), 0.709 (95% CI: 0.634-0.777), 0.723 (95% CI: 0.649-0.789), and 0.728 (95% CI: 0.654-0.793), respectively. Conversely, the WBC and PLT counts demonstrated poor diagnostic value for PJI, with AUC values of 0.578 (95% CI: 0.499-0.653) and 0.694 (95% CI: 0.619-0.763), respectively. The results of the prediction model calculations revealed that the combined AUC of the ESR, CRP, PLR, PVR, NLR, and MLR was the highest at 0.841 (95% CI, 0.77-0.893), indicating good value in the diagnosis of PJI, with a sensitivity of 81.0% and a specificity of 72.7%. Moreover, the novel composite of parameters improved the accuracy and reliability in diagnosing PJI compared to the traditional biomarkers ESR and CRP (P < 0.05). Conclusion: Our study suggested that the diagnostic value of the peripheral blood biomarkers PLR, PVR, NLR, and MLR for diagnosing PJI is limited and not superior to that of the ESR or CRP. However, when the ESR, CRP, PLR, PVR, NLR, and MLR are combined, the diagnostic performance of PJI in AJR patients can be improved.

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“…These biomarkers offer a range of advantages, including simplicity, speed, affordability, and so on. A study by Wang et al revealed that PVR is a valuable biomarker for the early diagnosis of infectious bone nonunion [ 27 ]. Recent investigations have also shown the potential of the PLR and PVR in aiding PJI diagnosis [ 28 , 29 ].…”

Section: Discussionmentioning

confidence: 99%

Different biomarker ratios in peripheral blood have limited value in diagnosing periprosthetic joint infection after total joint arthroplasty: a single-center, retrospective study

Deng,

Wang,

Yang

et al. 2024

BMC Musculoskelet Disord

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Background Periprosthetic joint infection (PJI) is a severe complication that can occur after total joint arthroplasty (TJA). The timely and accurate diagnosis of PJI is the key to treatment. This study investigated the diagnostic value of platelet to lymphocyte ratio (PLR), platelet count to mean platelet volume ratio (PVR), neutrophil to lymphocyte ratio (NLR) and monocyte to lymphocyte ratio (MLR) in PJI after total knee arthroplasty (TKA) and total hip arthroplasty (THA). Methods We performed a retrospective analysis of the patients who underwent revision hip or knee arthroplasty at our Institute between June 2015 and June 2020. Of the 187 patients reviewed, 168 were included in the study. According to the diagnostic criteria of the Musculoskeletal Infection Society (MSIS), 58 patients were in the PJI group, and 110 patients were in the aseptic loosening (AL) group. We recorded and compared the preoperative peripheral blood white blood cell (WBC) count, platelet count (PLT), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), PLR, PVR, NLR, and MLR in both groups. The diagnostic performance of the WBC, PLT, PLR, PVR, NLR, and MLR individually and in combination with the ESR and CRP for PJI diagnosis was evaluated by receiver operating characteristic (ROC) curves, and the sensitivity, specificity, positive predictive value, and negative predictive value were calculated. Results Compared to those in the AL group, the mean WBC, PLT, ESR, CRP, PLR, PVR, NLR, and MLR in the peripheral blood of the PJI group were significantly greater (P < 0.05). The analysis of the ROC curve revealed that the ESR, CRP, PLR, PVR, NLR, and MLR in peripheral blood had moderate effectiveness in diagnosing PJI, with area under the curve (AUC) values of 0.760 (95% CI: 0.688–0.823), 0.758 (95% CI: 0.687–0.821), 0.714 (95% CI: 0.639–0.781), 0.709 (95% CI: 0.634–0.777), 0.723 (95% CI: 0.649–0.789), and 0.728 (95% CI: 0.654–0.793), respectively. Conversely, the WBC and PLT counts demonstrated poor diagnostic value for PJI, with AUC values of 0.578 (95% CI: 0.499–0.653) and 0.694 (95% CI: 0.619–0.763), respectively. The results of the prediction model calculations revealed that the combined AUC of the WBC, PLT, ESR, CRP, PLR, PVR, NLR, and MLR was the highest at 0.853 (95% CI, 0.790–0.909), indicating good value in the diagnosis of PJI, with a sensitivity of 82.8% and a specificity of 72.7%. Moreover, the novel composite of parameters improved the accuracy and reliability in diagnosing PJI compared to the traditional biomarkers ESR and CRP (P = 0.015). Conclusion Our study suggested that the diagnostic value of the peripheral blood biomarkers PLR, PVR, NLR, and MLR for diagnosing PJI is limited and not superior to that of the ESR or CRP. However, when the WBC, PLT, ESR, CRP, PLR, PVR, NLR, and MLR are combined, the diagnostic performance of PJI in TJA patients can be improved.

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Diagnostic value of platelet indices in infected nonunion: a retrospective study

Cited by 6 publications

References 37 publications

Analysis of fracture-related infections from Swedish insurance claims between 2011 and 2021

Analysis of fracture-related infections from Swedish insurance claims between 2011 and 2021

Different Biomarker Ratios in Peripheral Blood have Limited Value in Diagnosing Periprosthetic Joint Infection after Artificial Joint Replacement：A Single-Center, Retrospective Study

Different biomarker ratios in peripheral blood have limited value in diagnosing periprosthetic joint infection after total joint arthroplasty: a single-center, retrospective study

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