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The role of fibrinogen in predicting reinfection after DAIR for periprosthetic joint infections

BACKGROUND: Fibrinogen (FIB) has been found to be a promising marker in diagnosing periprosthetic joint infection (PJI), however, the value of FIB in predicting reinfection of PJI is unknown. The purpose of this study was to evaluate the value of FIB in predicting reinfection after debridement, anti...

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Autores principales: Zhao, Dacheng, He, Jinwen, Wang, Xingwen, Zhao, Xiaobing, Xia, Yayi, Geng, Bin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8146659/
https://www.ncbi.nlm.nih.gov/pubmed/34030692
http://dx.doi.org/10.1186/s12891-021-04357-8
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author Zhao, Dacheng
He, Jinwen
Wang, Xingwen
Zhao, Xiaobing
Xia, Yayi
Geng, Bin
author_facet Zhao, Dacheng
He, Jinwen
Wang, Xingwen
Zhao, Xiaobing
Xia, Yayi
Geng, Bin
author_sort Zhao, Dacheng
collection PubMed
description BACKGROUND: Fibrinogen (FIB) has been found to be a promising marker in diagnosing periprosthetic joint infection (PJI), however, the value of FIB in predicting reinfection of PJI is unknown. The purpose of this study was to evaluate the value of FIB in predicting reinfection after debridement, antibiotics, and implant retention (DAIR) for PJI. METHODS: We retrospectively analyzed the clinical data of patients who were diagnosed with PJI and underwent DAIR from 2013 to 2019. The levels of the FIB, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were measured before DAIR. After DAIR, patients were followed and reinfections were identified. For both acute and chronic PJI, the predictive value of FIB was evaluated by calculating the sensitivity, specificity, and area under the curve (AUC) of the receiver operating characteristic curve (ROC), and was compared with traditional inflammatory markers including ESR and CRP. RESULTS: The expression of FIB differed between patients reinfected and those not reinfected in both acute and chronic PJI (p < 0.05). In patients who underwent DAIR for acute PJI, the sensitivity and specificity of FIB were 81.82 and 83.33%, respectively, which were significantly higher than that of CRP (sensitivity, 72.73%; specificity, 50%; p < 0.05), while the specificity was higher than that of ESR (specificity, 41.67%; p < 0.05). In patients who underwent DAIR for chronic PJI, the sensitivity and specificity of FIB were 80.00 and 66.66%, respectively, which were significantly higher than that of CRP (sensitivity, 53.33%; specificity, 66.66%; p < 0.05) and ESR (sensitivity was 66.00%; specificity, 16.66%; p < 0.05). The ROC curves showed that FIB demonstrated the highest AUC among the biomarkers in both acute and chronic PJI. CONCLUSION: FIB is a promising indicator in predicting reinfection after DAIR for both acute and chronic PJI, and it seems to perform better than ESR and CRP. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12891-021-04357-8.
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spelling pubmed-81466592021-05-25 The role of fibrinogen in predicting reinfection after DAIR for periprosthetic joint infections Zhao, Dacheng He, Jinwen Wang, Xingwen Zhao, Xiaobing Xia, Yayi Geng, Bin BMC Musculoskelet Disord Research BACKGROUND: Fibrinogen (FIB) has been found to be a promising marker in diagnosing periprosthetic joint infection (PJI), however, the value of FIB in predicting reinfection of PJI is unknown. The purpose of this study was to evaluate the value of FIB in predicting reinfection after debridement, antibiotics, and implant retention (DAIR) for PJI. METHODS: We retrospectively analyzed the clinical data of patients who were diagnosed with PJI and underwent DAIR from 2013 to 2019. The levels of the FIB, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were measured before DAIR. After DAIR, patients were followed and reinfections were identified. For both acute and chronic PJI, the predictive value of FIB was evaluated by calculating the sensitivity, specificity, and area under the curve (AUC) of the receiver operating characteristic curve (ROC), and was compared with traditional inflammatory markers including ESR and CRP. RESULTS: The expression of FIB differed between patients reinfected and those not reinfected in both acute and chronic PJI (p < 0.05). In patients who underwent DAIR for acute PJI, the sensitivity and specificity of FIB were 81.82 and 83.33%, respectively, which were significantly higher than that of CRP (sensitivity, 72.73%; specificity, 50%; p < 0.05), while the specificity was higher than that of ESR (specificity, 41.67%; p < 0.05). In patients who underwent DAIR for chronic PJI, the sensitivity and specificity of FIB were 80.00 and 66.66%, respectively, which were significantly higher than that of CRP (sensitivity, 53.33%; specificity, 66.66%; p < 0.05) and ESR (sensitivity was 66.00%; specificity, 16.66%; p < 0.05). The ROC curves showed that FIB demonstrated the highest AUC among the biomarkers in both acute and chronic PJI. CONCLUSION: FIB is a promising indicator in predicting reinfection after DAIR for both acute and chronic PJI, and it seems to perform better than ESR and CRP. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12891-021-04357-8. BioMed Central 2021-05-24 /pmc/articles/PMC8146659/ /pubmed/34030692 http://dx.doi.org/10.1186/s12891-021-04357-8 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Zhao, Dacheng
He, Jinwen
Wang, Xingwen
Zhao, Xiaobing
Xia, Yayi
Geng, Bin
The role of fibrinogen in predicting reinfection after DAIR for periprosthetic joint infections
title The role of fibrinogen in predicting reinfection after DAIR for periprosthetic joint infections
title_full The role of fibrinogen in predicting reinfection after DAIR for periprosthetic joint infections
title_fullStr The role of fibrinogen in predicting reinfection after DAIR for periprosthetic joint infections
title_full_unstemmed The role of fibrinogen in predicting reinfection after DAIR for periprosthetic joint infections
title_short The role of fibrinogen in predicting reinfection after DAIR for periprosthetic joint infections
title_sort role of fibrinogen in predicting reinfection after dair for periprosthetic joint infections
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8146659/
https://www.ncbi.nlm.nih.gov/pubmed/34030692
http://dx.doi.org/10.1186/s12891-021-04357-8
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