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Accuracy of a Novel Preoperative Failure Risk Model for Debridement Antibiotics and Implant Retention (DAIR) in Acute Prosthetic Joint Infection

Given the variable success of the debridement, antibiotics and implant retention (DAIR) procedure in patients with acute prosthetic joint infection (PJI), an accurate selection of candidates is critical. In this study, we set about calculating the predictive value of a novel algorithm for predicting...

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Autores principales: Sancho, Ignacio, Otermin-Maya, Iñaki, Gutiérrez-Dubois, Jorge, Aláez, Ignacio, Hidalgo-Ovejero, Ángel, Librero, Julián, Portillo, María Eugenia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9497597/
https://www.ncbi.nlm.nih.gov/pubmed/36140498
http://dx.doi.org/10.3390/diagnostics12092097
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author Sancho, Ignacio
Otermin-Maya, Iñaki
Gutiérrez-Dubois, Jorge
Aláez, Ignacio
Hidalgo-Ovejero, Ángel
Librero, Julián
Portillo, María Eugenia
author_facet Sancho, Ignacio
Otermin-Maya, Iñaki
Gutiérrez-Dubois, Jorge
Aláez, Ignacio
Hidalgo-Ovejero, Ángel
Librero, Julián
Portillo, María Eugenia
author_sort Sancho, Ignacio
collection PubMed
description Given the variable success of the debridement, antibiotics and implant retention (DAIR) procedure in patients with acute prosthetic joint infection (PJI), an accurate selection of candidates is critical. In this study, we set about calculating the predictive value of a novel algorithm for predicting outcome following DAIR developed by Shohat et al. Sixty-four patients who underwent debridement for (early and late) acute PJI in a tertiary-level university hospital were selected, and the aforementioned algorithm was retrospectively applied. Patients with model scores of 40–50%, 50–60%, 60–70%, 70–80% and 80–90% displayed success rates of 33.34%, 41.18%, 57.9%, 78.27% and 100%, respectively. The receiver operating characteristic curve showed an area under the curve of 0.69. The calibration intercept value was 0, and the calibration slope value was 1. Failure rates were significantly higher for the following variables: revision surgery (p = 0.012) index surgery for reasons other than osteoarthritis (p = 0.01), and C-reactive protein level >30 mg/L (p = 0.042). This analysis demonstrated that the Shohat algorithm is associated with an optimal calibration value and a moderate predictive value for failure of a DAIR procedure in patients with acute PJI. Its validation is recommended before it can be routinely applied in daily practice.
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spelling pubmed-94975972022-09-23 Accuracy of a Novel Preoperative Failure Risk Model for Debridement Antibiotics and Implant Retention (DAIR) in Acute Prosthetic Joint Infection Sancho, Ignacio Otermin-Maya, Iñaki Gutiérrez-Dubois, Jorge Aláez, Ignacio Hidalgo-Ovejero, Ángel Librero, Julián Portillo, María Eugenia Diagnostics (Basel) Article Given the variable success of the debridement, antibiotics and implant retention (DAIR) procedure in patients with acute prosthetic joint infection (PJI), an accurate selection of candidates is critical. In this study, we set about calculating the predictive value of a novel algorithm for predicting outcome following DAIR developed by Shohat et al. Sixty-four patients who underwent debridement for (early and late) acute PJI in a tertiary-level university hospital were selected, and the aforementioned algorithm was retrospectively applied. Patients with model scores of 40–50%, 50–60%, 60–70%, 70–80% and 80–90% displayed success rates of 33.34%, 41.18%, 57.9%, 78.27% and 100%, respectively. The receiver operating characteristic curve showed an area under the curve of 0.69. The calibration intercept value was 0, and the calibration slope value was 1. Failure rates were significantly higher for the following variables: revision surgery (p = 0.012) index surgery for reasons other than osteoarthritis (p = 0.01), and C-reactive protein level >30 mg/L (p = 0.042). This analysis demonstrated that the Shohat algorithm is associated with an optimal calibration value and a moderate predictive value for failure of a DAIR procedure in patients with acute PJI. Its validation is recommended before it can be routinely applied in daily practice. MDPI 2022-08-29 /pmc/articles/PMC9497597/ /pubmed/36140498 http://dx.doi.org/10.3390/diagnostics12092097 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Sancho, Ignacio
Otermin-Maya, Iñaki
Gutiérrez-Dubois, Jorge
Aláez, Ignacio
Hidalgo-Ovejero, Ángel
Librero, Julián
Portillo, María Eugenia
Accuracy of a Novel Preoperative Failure Risk Model for Debridement Antibiotics and Implant Retention (DAIR) in Acute Prosthetic Joint Infection
title Accuracy of a Novel Preoperative Failure Risk Model for Debridement Antibiotics and Implant Retention (DAIR) in Acute Prosthetic Joint Infection
title_full Accuracy of a Novel Preoperative Failure Risk Model for Debridement Antibiotics and Implant Retention (DAIR) in Acute Prosthetic Joint Infection
title_fullStr Accuracy of a Novel Preoperative Failure Risk Model for Debridement Antibiotics and Implant Retention (DAIR) in Acute Prosthetic Joint Infection
title_full_unstemmed Accuracy of a Novel Preoperative Failure Risk Model for Debridement Antibiotics and Implant Retention (DAIR) in Acute Prosthetic Joint Infection
title_short Accuracy of a Novel Preoperative Failure Risk Model for Debridement Antibiotics and Implant Retention (DAIR) in Acute Prosthetic Joint Infection
title_sort accuracy of a novel preoperative failure risk model for debridement antibiotics and implant retention (dair) in acute prosthetic joint infection
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9497597/
https://www.ncbi.nlm.nih.gov/pubmed/36140498
http://dx.doi.org/10.3390/diagnostics12092097
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