Plasma Fibrinogen and Platelet Count Are Referable Tools for Diagnosing Periprosthetic Joint Infection: A Single-Center Retrospective Cohort Study

Xu, Hong; Xie, Jinwei; Yang, Jing; Guo, Cheng; Huang, Qiang; Pei, Fuxing

doi:10.1016/j.arth.2019.12.015

Cited by 53 publications

(75 citation statements)

References 30 publications

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“…Patients were followed up at 2 weeks, 3 months, 6 months and 1 year respectively. In our previous study [11], we found that ESR is a less sensitive parameter compared to CRP and IL-6. In addition, the value of the ESR changed according to the two different diagnostic kits used in our institute.…”

Section: Methodsmentioning

confidence: 76%

Normal trajectory of Interleukin-6 and C-reactive protein in the perioperative period of total knee arthroplasty under an enhanced recovery after surgery scenario

Huang¹,

Huang²,

Wang³

et al. 2020

BMC Musculoskelet Disord

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Background: We designed the current study to understand the normal trajectories of interleukin-6 (IL-6) and Creactive protein (CRP) in the immediate hours and days after primary total knee arthroplasty (TKA) under the management of an enhanced recovery after surgery (ERAS) protocol and examined whether one or the other returned to normal more quickly. Methods: In this prospective cross-sectional study, we examined the plasma IL-6 and CRP levels in 100 patients undergoing primary TKA at the following time points: 12 h preoperatively as well as postoperatively 12 h, 48 h, 3 days and 2 weeks. Patients were followed up for 1 year to monitor the postoperative complications, especially the infection. Results: IL-6 peaked at 48 h postoperatively. Then IL-6 started to decline at 3 days postoperatively and went back to baseline level at 2 weeks (p = 0.950). CRP peaked at 3 days postoperatively. At 2 weeks, CRP declined to a normal range, without being significantly different from the baseline level (p = 0.816). Conclusion: We found that under the ERAS scenario, the postoperative peak of IL-6 and CRP was deferred compared with previous studies. Compared to IL-6, CRP showed a gradual rise after surgery. Both of these two biomarkers returned to normal under the ERAS scenario. Future multiple-center studies with larger sample size can help define the thresholds of IL-6 and CRP for periprosthetic joint infection (PJI) early diagnosis. With these reference data, a clinician can make a quicker decision to perform aspiration to diagnose early PJI and benefits more patients.

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Section: Methodsmentioning

confidence: 76%

Normal trajectory of Interleukin-6 and C-reactive protein in the perioperative period of total knee arthroplasty under an enhanced recovery after surgery scenario

Huang¹,

Huang²,

Wang³

et al. 2020

BMC Musculoskelet Disord

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“…For example, D-dimer was reported by Qin et al as a promising biomarker for diagnosing PJI [28] while Xu et al demonstrated that D-dimer had limited value [24]. Nonetheless, both biomarkers have lower diagnostic performance than ESR, CRP, and plasma fibrinogen which have been reported repeatedly to have better diagnostic power (in terms of AUC, sensitivity, specificity) in the diagnosis of PJI [5,8,22,23,29]. However, the AUC of globulin and A/G ratio was larger than 0.7, indicating an acceptable diagnostic performance.…”

Section: Discussionmentioning

confidence: 99%

Serum globulin and albumin to globulin ratio as potential diagnostic biomarkers for periprosthetic joint infection: a retrospective review

Chen

et al. 2020

J Orthop Surg Res

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Background Periprosthetic joint infection (PJI) has been increasingly documented; however, its preoperative accurate diagnosis remains challenging. Furthermore, there is a dire need to identify appropriate and effective biomarkers. We aimed to evaluate the relationship between globulin, albumin to globulin (A/G) ratio, and development of PJI in patients undergoing revision total joint arthroplasty (TJA). Methods A retrospective study was conducted on patients who had undergone revision TJA between 2011 and 2018 (89 with aseptic mechanic failure and 38 with PJI). The serum proteins were explored using univariate analysis followed by multivariate logistic regression. The diagnostic performance of these proteins was assessed by the receiver operating characteristic (ROC) curve. Results Higher globulin levels (odds ratio [OR], 1.239; P < 0.001) and lower A/G ratio (OR, 0.007; P < 0.001) were strongly associated with the risk of PJI. ROC curve analysis demonstrated reasonable diagnostic performance for globulin (area under the curve [AUC], 0.77; sensitivity, 78.95%; and specificity, 69.66%) and A/G ratio (AUC, 0.779; sensitivity, 65.79%; and specificity, 78.65%). Conclusions Both globulin and A/G ratio were associated with PJI and may serve as potential adjuvant biomarkers in the diagnosis of PJI.

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“…Further, ROC curve analysis revealed that globulin and A/G ratio showed acceptable predictive value for the diagnosis of PJI. Nonetheless, both biomarkers have a lower diagnostic performance than ESR and CRP which have been reported repeatedly to have better diagnostic power (in terms of AUC, sensitivity, speci city) in the diagnosis of PJI [5,8,22]. However, the AUC of globulin and A/G ratio was larger than 0.7, indicating an acceptable diagnostic performance.…”

Section: Discussionmentioning

confidence: 89%

Serum Globulin and Albumin to Globulin Ratio as Potential Diagnostic Biomarkers for Periprosthetic Joint Infection: A Retrospective Review

Chen

et al. 2020

Preprint

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Background: Periprosthetic joint infection (PJI) has been increasingly documented; however, its preoperative accurate diagnosis remains challenging. Furthermore, there is a dire need to identify appropriate and effective biomarkers. We aimed to evaluate the relationship between globulin, albumin to globulin (A/G) ratio, and development of PJI in patients undergoing revision total joint arthroplasty (TJA). Methods: A retrospective study was conducted on patients who had undergone revision TJA between 2011 and 2018 (89 with aseptic mechanic failure and 38 with PJI). The serum proteins were explored using univariate analysis followed by multivariate logistic regression. The diagnostic performance of these proteins was assessed by the receiver operating characteristic (ROC) curve. Results: Higher globulin levels (odds ratio [OR], 1.239; P<0.001) and lower A/G ratio (OR, 0.007; P<0.001) were strongly associated with the risk of PJI. ROC curve analysis demonstrated reasonable diagnostic performance for globulin (area under the curve [AUC], 0.77; sensitivity, 78.95%; and specificity, 69.66%) and A/G ratio (AUC, 0.779; sensitivity, 65.79%; and specificity, 78.65%). Conclusions: Both globulin and A/G ratio were associated with PJI and may serve as potential adjuvant biomarkers in the diagnosis of PJI.

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Plasma Fibrinogen and Platelet Count Are Referable Tools for Diagnosing Periprosthetic Joint Infection: A Single-Center Retrospective Cohort Study

Cited by 53 publications

References 30 publications

Normal trajectory of Interleukin-6 and C-reactive protein in the perioperative period of total knee arthroplasty under an enhanced recovery after surgery scenario

Normal trajectory of Interleukin-6 and C-reactive protein in the perioperative period of total knee arthroplasty under an enhanced recovery after surgery scenario

Serum globulin and albumin to globulin ratio as potential diagnostic biomarkers for periprosthetic joint infection: a retrospective review

Serum Globulin and Albumin to Globulin Ratio as Potential Diagnostic Biomarkers for Periprosthetic Joint Infection: A Retrospective Review

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