Meier Marc-Pascal, Bauer Ina Juliana, Maheshwari Arvind K, Husen Martin, Jäckle Katharina, Hubert Jan, Hawellek Thelonius, Lehmann Wolfgang, Saul Dominik
Department of Trauma, Orthopedics and Reconstructive Surgery, Georg-August-University of Goettingen, 37075 Göttingen, Germany.
Kogod Center on Aging and Division of Endocrinology, Mayo Clinic, Rochester, MN 55905, USA.
J Clin Med. 2021 Oct 27;10(21):4985. doi: 10.3390/jcm10214985.
While primary hip arthroplasty is the most common operative procedure in orthopedic surgery, a periprosthetic joint infection is its most severe complication. Early detection and prediction are crucial. In this study, we aimed to determine the value of postoperative C-reactive protein (CRP) and develop a formula to predict this rare, but devastating complication.
We retrospectively evaluated 708 patients with primary hip arthroplasty. CRP, white blood cell count (WBC), and several patient characteristics were assessed for 20 days following the operative procedure.
Eight patients suffered an early acute periprosthetic infection. The maximum CRP predicted an infection with a sensitivity and specificity of 75% and 56.9%, respectively, while a binary logistic regression reached values of 75% and 80%. A multinominal logistic regression, however, was able to predict an early infection with a sensitivity and specificity of 87.5% and 78.9%. With a one-phase decay, 71.6% of the postoperative CRP-variance could be predicted.
To predict early acute periprosthetic joint infection after primary hip arthroplasty, a multinominal logistic regression is the most promising approach. Including five parameters, an early infection can be predicted on day 5 after the operative procedure with 87.5% sensitivity, while it can be excluded with 78.9% specificity.
虽然初次髋关节置换术是骨科手术中最常见的手术操作，但假体周围关节感染是其最严重的并发症。早期检测和预测至关重要。在本研究中，我们旨在确定术后C反应蛋白（CRP）的价值，并开发一种公式来预测这种罕见但具有毁灭性的并发症。
我们回顾性评估了708例行初次髋关节置换术的患者。在手术后20天内评估CRP、白细胞计数（WBC）以及一些患者特征。
8例患者发生早期急性假体周围感染。最大CRP预测感染的敏感性和特异性分别为75%和56.9%，而二元逻辑回归的敏感性和特异性分别为75%和80%。然而，多项逻辑回归能够预测早期感染，敏感性和特异性分别为87.5%和78.9%。采用单相衰减，术后CRP变异的71.6%可以被预测。
为预测初次髋关节置换术后早期急性假体周围关节感染，多项逻辑回归是最有前景的方法。纳入五个参数，术后第5天可预测早期感染，敏感性为87.5%，同时可排除78.9%的特异性。
