Plasma fibrinogen may predict persistent infection before reimplantation in two-stage exchange arthroplasty for periprosthetic hip infection.
J Orthop Surg Res
; 14(1): 133, 2019 May 14.
Article
em En
| MEDLINE
| ID: mdl-31088508
ABSTRACT
BACKGROUND:
The diagnosis of persistent infection before reimplantation in two-stage exchange arthroplasty for periprosthetic joint infection (PJI) remains challenging. Currently, several studies suggested coagulation-related markers, such as D-dimer and fibrinogen, may be promising in diagnose of PJI. The purpose of the study was to investigate the predictive values of plasma D-dimer and fibrinogen for assessment of persistent infection before reimplantation hip arthroplasty.METHODS:
We retrospectively reviewed 129 hips that treated with two-stage exchange arthroplasty for PJI from 2012 to 2016 in our institution. The persistent infection before reimplantation was based on a modified Musculoskeletal Infection Society (MSIS) criteria. After exclusion, 102 hips were included in the final analysis. Receiver operating characteristic (ROC) curves were generated to determine the prognostic value of plasma D-dimer and fibrinogen in predicting persistent infection before reimplantation.RESULTS:
The area the under ROC curves (AUC) for fibrinogen (0.773; 95% confidential interval [CI], 0.569-0.905) was significantly higher than that of D-dimer (0.565; 95% CI, 0.329-0.777). With the calculated threshold of fibrinogen set at 3.61 g/L, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) was 87.5%, 62.8%, 16.7%, and 98.3%, respectively. With the threshold value of D-dimer set at 0.82 µg/mL, the sensitivity, specificity, PPV, and NPV was 83.3%, 41.9%, 21.7%, and 92.9%, respectively.CONCLUSIONS:
In conclusion, the current study reveals that the plasma fibrinogen may be a promising biomarker in predicting persistent infection before reimplantation. Further prospective studies with larger cohorts are needed to validate predictive values and optimal thresholds of coagulation-related markers.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Cuidados Pré-Operatórios
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Fibrinogênio
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Infecções Relacionadas à Prótese
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Artroplastia de Quadril
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Prótese de Quadril
Tipo de estudo:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Humans
/
Middle aged
Idioma:
En
Revista:
J Orthop Surg Res
Ano de publicação:
2019
Tipo de documento:
Article