Thurston Catherine C, Stefanovski Darko, MacKinnon Melissa C, Chapman Hannah-Sophie, Richardson Dean W, Levine David G
New Bolton Center, Department of Clinical Studies, University of Pennsylvania, Kennett Square, PA, United States.
Department of Population Medicine, University of Waterloo, Waterloo, ON, Canada.
Front Vet Sci. 2022 Oct 10;9:960865. doi: 10.3389/fvets.2022.960865. eCollection 2022.
The objective of this study was to determine the diagnostic ability of serum amyloid A (SAA) and fibrinogen for early detection of surgical site infection (SSI) after equine internal fixation. Horses undergoing internal fixation for fracture, arthrodesis, or osteotomy with internal fixation for limb deformity were included in the study. SAA and fibrinogen were measured on blood samples preoperatively and on days 1, 3, 5, 7, 10, and 14 postoperatively. Statistical analysis included use of Spearman's rank correlation, logistic regression, and calculating the area under the receiver operating characteristic (ROC) curve. SAA and fibrinogen measurements were both associated with SSI, with SAA being considered an excellent marker (area under the ROC curve 0.8) and fibrinogen being considered acceptable (<0.8). As the amount of time postoperatively increased, SAA elevations indicated a higher likelihood of SSI (area under the ROC curve 0.8 compared with fibrinogen 0.7). SAA and fibrinogen were predictive markers of SSI and SAA is of greater diagnostic utility when compared with fibrinogen. Persistent elevations of SAA postoperatively are associated with the development of SSI. Serial monitoring of SAA can be used to help predict the development of SSI in horses undergoing internal fixation. This may lead to earlier suspicion, and therefore recognition and treatment of SSI.
本研究的目的是确定血清淀粉样蛋白A（SAA）和纤维蛋白原在早期检测马内固定术后手术部位感染（SSI）方面的诊断能力。纳入研究的马包括接受骨折内固定、关节固定术或肢体畸形截骨内固定术的马匹。在术前以及术后第1、3、5、7、10和14天采集血样测定SAA和纤维蛋白原。统计分析包括使用Spearman等级相关性分析、逻辑回归分析以及计算受试者工作特征（ROC）曲线下面积。SAA和纤维蛋白原的测量值均与SSI相关，SAA被认为是一个优秀的标志物（ROC曲线下面积为0.8），纤维蛋白原被认为是可接受的（<0.8）。随着术后时间的增加，SAA升高表明发生SSI的可能性更高（ROC曲线下面积为0.8，而纤维蛋白原为0.7）。SAA和纤维蛋白原是SSI的预测标志物，与纤维蛋白原相比，SAA具有更大的诊断效用。术后SAA持续升高与SSI的发生有关。对接受内固定术的马匹连续监测SAA可用于帮助预测SSI的发生。这可能会导致更早的怀疑，从而更早地识别和治疗SSI。
