Coagulation Factors for Diagnosis of Periprosthetic Joint Infection
10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.2023.0202
- VernacularTitle:凝血相关指标在关节假体周围感染中的诊断价值
- Author:
Xiao-yu WU
1
;
Yong-yu YE
2
;
Bai-qi PAN
1
;
Xuan-tao HU
1
;
Lin-li ZHENG
1
;
Wei-shen CHEN
1
;
Zi-ji ZHANG
1
;
Pu-yi SHENG
1
Author Information
1. Department of Joint Surgery， The First Affiliated Hospital of Sun Yat-sen University， Guangzhou 510080， China
2. Department of Orthopedics， Guangdong Provincial People's Hospital， Guangzhou， 510080， China
- Publication Type:Journal Article
- Keywords:
periprosthetic joint infection;
plasma fibrinogen;
coagulation-related indicators;
diagnosis
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2023;44(2):188-197
- CountryChina
- Language:Chinese
-
Abstract:
ObjectivePeriprosthetic joint infections （PJI） are currently the most calamitous complication after arthroplasty. Although achievements have been made in many markers for the diagnosis of PJI， the lack of a gold standard remains a great obstacle for early diagnosis. This study aimed to investigate the association between coagulation markers and the development of PJI in patients undergoing revision total joint arthroplasty （TJA）. MethodsWe conducted a retrospective cohort study with a total of 2 517 patients who underwent hip or knee arthroplasties from January 2011 to January 2022 （2 394 with primary TJA， 87 with aseptic revision and 36 with PJI）. We applied univariate analysis and multivariate logistic regression to analyze differences of coagulation factors between primary TJA and aseptic revision or PJI group. Receiver operating characteristic （ROC） curve and area under the curve （AUC） were used to measure the diagnostic value of coagulation factors in predicting PJI. ResultsCoagulation factors and their ratios including plasma fibrinogen （FBG）， prothrombin time （PT）， thrombin time （TT）， activated partial thromboplastin time （APTT）， platelet （PLT）， mean platelet volume （MPV）， platelet distribution width （PDW）， plateletcrit （PCT）， PLT / MPV， PLT / PDW and PLT / PCT were included in this study. High FGB level was strongly correlated with the risk of PJI compared to other coagulation factors. The optimal threshold value of FBG was 4.53 g/L with a sensitivity of 47.22%， a specificity of 93.07% （Primary TJA group vs. PJI group）. Similarly， the optimal threshold value of FBG was 4.44 g/L with a sensitivity of 47.22%， a specificity of 95.40% between the other two groups （Aseptic revision group vs. PJI group）. ROC curve analysis demonstrated moderate diagnostic performance of FBG （AUC value）， indicating a potential to be a diagnostic marker for PJI. ConclusionsFBG is significantly correlated with PJI and it can be used as a potential non-invasive marker for early detection. It may serve as a safe and cost-effective tool for assessing PJI in clinical work.
