Diagnostic cutoff values of synovial fluid biomarkers for acute postoperative prosthetic joint infection: a systematic review and meta-analysis

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-01-29 DOI:10.5194/jbji-9-17-2024

Marta Sabater-Martos, Marc Ferrer, L. Morata, Álex Soriano, J. Martínez-Pastor

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引用次数: 0

Abstract

Abstract. Introduction: The assessment of white blood cell (WBC) count and polymorphonuclear cell (PMN) percentage in synovial fluid can help in the diagnosis of acute postoperative peri-prosthetic joint infection (PJI). Their cutoff values, which would differ from those for chronic PJI, have not yet been determined in acute postoperative PJI. The aim of this study was (1) to analyse studies reporting the optimal cutoff values for WBC count and the PMN percentage in synovial fluid and (2) to determine which is the best diagnostic tool for acute postoperative PJI. Methods: We performed a systematic review (SR) of primary studies analysing WBC count and the PMN percentage for diagnosis of acute postoperative PJI. A search was performed in MEDLINE and EMBASE. We studied the risk of bias and quality assessment. We extracted data on cutoff values, sensitivity, specificity, positive and negative predictive value, area under the curve, and accuracy. We calculated the diagnosis odds ratio (DOR), performed the meta-analysis and summarized receiver operating curves (sROCs) for WBC count and the PMN percentage. Results: We included six studies. WBC count showed a DOR of 123.61 (95 % CI: 55.38–275.88), an sROC with an area under the curve (AUC) of 0.96 (SE: 0.009) and a Q index of 0.917. The PMN percentage showed a summary DOR of 18.71 (95 % CI: 11.64–30.07), an sROC with an AUC 0.88 (SE: 0.018) and a Q index of 0.812. Conclusion: We concluded that WBC count and the PMN percentage are useful tests for the diagnosis of acute PJI; WBC is the more powerful of the two. Studies centred on other synovial fluid biomarkers not yet studied could help in this diagnosis.

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滑膜液生物标志物对术后假体关节急性感染的诊断临界值：系统综述和荟萃分析

摘要简介：滑液中白细胞（WBC）计数和多形核细胞（PMN）百分比的评估有助于诊断急性术后假体周围关节感染（PJI）。它们的临界值与慢性 PJI 的临界值不同，但在急性术后 PJI 中的临界值尚未确定。本研究的目的是：(1) 分析报告滑液中白细胞计数和 PMN 百分比最佳临界值的研究；(2) 确定哪种是急性术后 PJI 的最佳诊断工具。方法：我们对用于诊断急性术后 PJI 的白细胞计数和 PMN 百分比的主要研究进行了系统性回顾（SR）。我们在 MEDLINE 和 EMBASE 中进行了检索。我们研究了偏倚风险和质量评估。我们提取了有关临界值、敏感性、特异性、阳性和阴性预测值、曲线下面积和准确性的数据。我们计算了诊断几率比（DOR），对白细胞计数和 PMN 百分比进行了荟萃分析并总结了接收者操作曲线（sROC）。结果我们纳入了六项研究。白细胞计数的DOR为123.61（95 % CI：55.38-275.88），sROC的曲线下面积（AUC）为0.96（SE：0.009），Q指数为0.917。PMN 百分比的总 DOR 为 18.71（95 % CI：11.64-30.07），sROC 的 AUC 为 0.88（SE：0.018），Q 指数为 0.812。结论我们得出的结论是，白细胞计数和 PMN 百分比是诊断急性 PJI 的有用检测方法；其中白细胞的作用更大。以尚未研究的其他滑液生物标志物为中心的研究可能有助于诊断。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.