Department of Orthopedics, The People's Hospital of Bozhou, Bozhou, 236800, Anhui, China.
West China School of Basic Medical Science & Forensic Medicine, Sichuan University, Chendu, 610041, China.
Sci Rep. 2021 Jan 12;11(1):677. doi: 10.1038/s41598-020-80547-z.
Periprosthetic joint infections (PJIs) have become the most catastrophic complication for patients after arthroplasty. Although previous studies have found that many biomarkers have good performance for diagnosing PJI, early diagnosis remains challenging and a gold standard is lacking. This study aimed to investigate the diagnostic accuracy of plasma fibrinogen (FIB) in detecting PJI compared to other traditional biomarks (CRP, WBC and ESR). A total of 156 patients (including 57 PJI and 99 non-PJI patients) who underwent revision arthroplasty were retrospectively reviewed from 01/2014 to 01/2020. The diagnostic criteria of PJI were mainly based on the definition from the evidence-based definition for periprosthetic joint infection in 2018. The optimal plasma FIB predictive cutoff was 4.20 g/L, the sensitivity of the plasma fibrinogen was 0.860, the specificity was 0.900, the positive predictive value (PPV) was 0.831, and the negative predictive value (NPV) was 0.908. The area under the curve (AUC) value of plasma fibrinogen was 0.916 (95% CI 0.869-0.964), and the CRP, ESR and WBC levels had AUCs of 0.901, 0.822 and 0.647, respectively. Plasma FIB demonstrated better diagnostic strength compared with that of other serum biomarkers before revision arthroplasty. It represents a new horizon for the diagnosis of PJI due to the diagnosis values and cost-effective features.
人工关节周围感染（PJI）已成为关节置换术后患者最灾难性的并发症。尽管先前的研究发现许多生物标志物在诊断 PJI 方面具有良好的性能，但早期诊断仍然具有挑战性，并且缺乏金标准。本研究旨在探讨与其他传统生物标志物（CRP、WBC 和 ESR）相比，血浆纤维蛋白原（FIB）在检测 PJI 中的诊断准确性。回顾性分析了 2014 年 1 月至 2020 年 1 月期间接受翻修关节置换术的 156 例患者（包括 57 例 PJI 和 99 例非 PJI 患者）。PJI 的诊断标准主要基于 2018 年基于循证的人工关节周围感染定义。最佳血浆 FIB 预测截断值为 4.20g/L，血浆纤维蛋白原的灵敏度为 0.860，特异性为 0.900，阳性预测值（PPV）为 0.831，阴性预测值（NPV）为 0.908。血浆纤维蛋白原的曲线下面积（AUC）值为 0.916（95%CI 0.869-0.964），CRP、ESR 和 WBC 水平的 AUC 值分别为 0.901、0.822 和 0.647。与术前翻修关节置换术时的其他血清生物标志物相比，血浆 FIB 显示出更好的诊断强度。由于诊断价值和成本效益特征，它代表了 PJI 诊断的一个新领域。
