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全膝关节置换术后假体周围感染风险及 C-反应蛋白/白蛋白比值的预测价值。

Periprosthetic infection risks and predictive value of C-reactive protein / albumin ratio for total joint arthroplasty.

机构信息

Department of Orthopaedic Surgery, Dicle University, Faculty of Medicine, Diyarbakır, Turkey.

出版信息

Acta Biomed. 2021 Sep 2;92(4):e2021324. doi: 10.23750/abm.v92i4.10995.

DOI:10.23750/abm.v92i4.10995
PMID:34487091
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8477118/
Abstract

BACKGROUND AND AIM

There are no gold standard markers to estimate the risk of developing periprosthetic infections. Our aim is to compare the risks of periprosthetic infection in patients with THA and THA and to investigate the predictive significance of the CRP / albumin ratio.

METHODS

This is a retrospective study containing data from 241 osteoarthritis patients and 19 patients with periprosthetic infections who underwent TKA and THA in our hospital from January 2014 to January 2019.12 risk factors(CRP/ albumin, albumin, CRP, age, gender, BMI, DM, ASA, nasal culture, urine culture, hospital stay, operation time) were analyzed.

RESULTS

In the binary logistic regression model and multivariate regression analysis, the rate of CRP / albumin was 17.161 times higher than the patients with ≤0.16 cut-off value. (CRP / albumin ratio (odds ratio (OR) = 17.16, 95% CI: 1.55-189.03, P: 0.02). High BMI increased the risk of periprosthetic infection 1.3 times. Nasal bacterial colonization (OR = 0.99, 95% CI: 0.868-1.38, P: 0.7) and bacterium in urine (OR = 0.502, 95% CI: 0.07-3.598, P: 0.703) did not pose a significant risk for periprosthetic infection.

CONCLUSION

According to our findings, the CRP / albumin ratio has a more prognostic capacity than other risks in determining the risk of periprosthetic infection for total joint arthroplasty. CRP / albumin ratio is a cheap and easy to apply marker. Routine urine and nasal bacteria screening is not required before total joint arthroplasty.

摘要

背景与目的

目前尚无金标准标志物来评估发生假体周围感染的风险。我们旨在比较全髋关节置换术(THA)和髋关节表面置换术(THA)患者发生假体周围感染的风险,并探讨 C 反应蛋白/白蛋白比值的预测意义。

方法

这是一项回顾性研究,纳入了 2014 年 1 月至 2019 年 1 月在我院行 TKA 和 THA 的 241 例骨关节炎患者和 19 例假体周围感染患者的数据。分析了 12 个危险因素(C 反应蛋白/白蛋白、白蛋白、C 反应蛋白、年龄、性别、BMI、糖尿病、ASA 分级、鼻腔培养、尿液培养、住院时间、手术时间)。

结果

在二元逻辑回归模型和多变量回归分析中,C 反应蛋白/白蛋白比值>0.16 截断值的患者发生假体周围感染的风险是 C 反应蛋白/白蛋白比值≤0.16 截断值患者的 17.161 倍。(C 反应蛋白/白蛋白比值(比值比(OR)=17.16,95%CI:1.55-189.03,P:0.02)。高 BMI 使假体周围感染的风险增加 1.3 倍。鼻腔细菌定植(OR=0.99,95%CI:0.868-1.38,P:0.7)和尿液细菌(OR=0.502,95%CI:0.07-3.598,P:0.703)与假体周围感染的风险无显著相关性。

结论

根据我们的发现,C 反应蛋白/白蛋白比值在确定全关节置换术假体周围感染风险方面比其他风险具有更好的预后能力。C 反应蛋白/白蛋白比值是一种廉价且易于应用的标志物。在进行全关节置换术前不需要常规进行尿液和鼻腔细菌筛查。

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