Kars Harakani State Hospital, Kars, Turkey.
Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Department of orthopaedics, Istanbul, Turkey.
Orthop Traumatol Surg Res. 2021 Jun;107(4):102899. doi: 10.1016/j.otsr.2021.102899. Epub 2021 Mar 24.
Numerous tests are being evaluated in order to aid the diagnosis of periprosthetic infections since it is a complicated and sometimes inconclusive process. The purpose of this study was to assess the diagnostic performance of platelet count to mean platelet volume ratio as a tool to aid the diagnosis of periprosthetic joint infections. The investigated questions were: "Is platelet count/mean platelet volume ratio more sensitive or specific than C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR) in the diagnosis of periprosthetic joint infections?" and "Does platelet count/mean platelet volume ratio increase the accuracy of periprosthetic joint infection diagnosis?".
Platelet count/mean platelet volume ratio increases the accuracy of periprosthetic joint infection diagnosis.
This study was performed retrospectively on patients who underwent revision hip or knee arthroplasty between 2016 and 2019. 62 patients with 33 aseptic (AR) and 29 septic revision (SR) who met our inclusion criteria were included. The sensitivity, specificity and diagnostic performance of CRP, ESR and platelet count/mean platelet volume values were analyzed and compared.
The demographic characteristics were similar between groups. Staphylococcus aureus and Staphylococcus epidermidis were the most commonly encountered microorganisms, while seven patients had negative cultures in SR group. ESR, CRP and platelet count/mean platelet volume values were significantly higher in SR group compared to AR group (p<0.01). ROC analysis for platelet count/mean platelet volume ratio revealed a cut-off value at 35.3 which provided 75.9% sensitivity and 78.8% specificity for periprosthetic joint infections. Platelet count/mean platelet volume ratio yielded lower sensitivity and similar specificity compared to ESR and CRP values. Platelet count/mean platelet volume had a lower area under curve value, indicating a poorer diagnostic performance compared to ESR and CRP.
The diagnostic performance of platelet count/mean platelet volume ratio is low and current findings do not support its usage to increase the accuracy of periprosthetic joint infections diagnosis.
III; diagnostic case-control study.
为了帮助诊断假体周围感染，人们正在评估许多测试，因为这是一个复杂且有时不确定的过程。本研究的目的是评估血小板计数与平均血小板体积比值作为辅助诊断假体周围关节感染的工具的诊断性能。研究的问题是：“血小板计数/平均血小板体积比值在诊断假体周围关节感染方面比 C 反应蛋白（CRP）或红细胞沉降率（ESR）更敏感或更特异？”和“血小板计数/平均血小板体积比值是否会提高假体周围关节感染诊断的准确性？”。
血小板计数/平均血小板体积比值提高了假体周围关节感染诊断的准确性。
本研究是对 2016 年至 2019 年间接受髋关节或膝关节翻修手术的患者进行的回顾性研究。符合纳入标准的 62 例患者中，33 例为无菌性（AR），29 例为感染性（SR）。分析比较了 CRP、ESR 和血小板计数/平均血小板体积值的敏感性、特异性和诊断性能。
两组的人口统计学特征相似。金黄色葡萄球菌和表皮葡萄球菌是最常见的微生物，而 SR 组中有 7 例培养阴性。与 AR 组相比，SR 组的 ESR、CRP 和血小板计数/平均血小板体积值显著升高（p<0.01）。ROC 分析血小板计数/平均血小板体积比值的截断值为 35.3，对假体周围关节感染的敏感性为 75.9%，特异性为 78.8%。与 ESR 和 CRP 值相比，血小板计数/平均血小板体积比值的敏感性较低，但特异性相似。血小板计数/平均血小板体积的曲线下面积值较低，表明与 ESR 和 CRP 相比，其诊断性能较差。
血小板计数/平均血小板体积比值的诊断性能较低，目前的研究结果不支持其用于提高假体周围关节感染诊断的准确性。
III；诊断病例对照研究。
