Diagnostic Accuracy of Rotational Thromboelastometry for Low-Virulence Periprosthetic Joint Infections: A Pilot Study.

IF 4.1 2区生物学 Q2 MICROBIOLOGY

Microorganisms Pub Date : 2024-08-22 DOI:10.3390/microorganisms12081740

Andreas G Tsantes, Aglaia Domouchtsidou, Konstantina A Tsante, Petros Ioannou, Alexandra Mpakosi, Eleni Petrou, Stavros Goumenos, Ioannis G Trikoupis, Anastasios G Roustemis, Sotirios P Fortis, Christos Koutserimpas, Panayiotis J Papagelopoulos, George Samonis, Stefanos Bonovas, Dimitrios V Papadopoulos

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引用次数: 0

Abstract

Background: Periprosthetic joint infections (PJIs) are associated with altered coagulation dynamics; therefore, coagulation laboratory studies could be valuable for diagnosing PJI. This study aimed to evaluate the diagnostic role of Rotational Thromboelastometry (ROTEM) in detecting PJIs caused by low-virulence pathogens.

Methods: A retrospective study was conducted, enrolling 78 patients who underwent exchange arthroplasty due to PJI due to high-virulence pathogens (Group A, n = 16), low-virulence pathogens (Group B, n = 20), or due to aseptic loosening (Group C, n = 20). Preoperative laboratory findings were compared among the three groups.

Results: Several ROTEM parameters differed in patients with PJIs caused by low-virulence pathogens, indicating a link between these infections and hypercoagulability. The development of low-virulence PJIs was associated with a higher maximum clot firmness (MCF) (Odds Ratio, 1.12; 95% Confidence Interval, 1.04-1.21; p = 0.001). Additionally, EXTEM MCF was found to have the highest diagnostic accuracy for these infections (Area Under the Curve, 0.841; sensitivity 90.0%; specificity 90.4%), surpassing that of C-reactive protein and the Erythrocyte Sedimentation Rate (p = 0.006 and p = 0.019, respectively).

Conclusions: Our findings suggest that ROTEM analysis is a promising method for detecting the altered hemostatic dynamics associated with PJI caused by low-virulence pathogens.

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旋转血栓弹性仪对低毒性假体周围关节感染的诊断准确性：一项试点研究。

背景：假体周围关节感染（PJI）与凝血动力学改变有关；因此，凝血实验室研究对诊断PJI很有价值。本研究旨在评估旋转血栓弹性测定法（ROTEM）在检测由低毒性病原体引起的假关节感染中的诊断作用：方法：我们进行了一项回顾性研究，纳入了78例因高致病菌（A组，n = 16）、低致病菌（B组，n = 20）或无菌性松动（C组，n = 20）引起的PJI而接受关节置换术的患者。比较了三组患者的术前实验室检查结果：结果：由低致病菌引起的PJI患者的多项ROTEM参数存在差异，表明这些感染与高凝状态之间存在联系。低毒性 PJI 的发生与较高的最大凝块坚固度（MCF）有关（Odds Ratio，1.12；95% 置信区间，1.04-1.21；p = 0.001）。此外，还发现 EXTEM MCF 对这些感染具有最高的诊断准确性（曲线下面积，0.841；敏感性 90.0%；特异性 90.4%），超过了 C 反应蛋白和红细胞沉降率（分别为 p = 0.006 和 p = 0.019）：我们的研究结果表明，ROTEM分析是一种很有前途的方法，可用于检测与低致病力病原体引起的PJI相关的止血动态变化。

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

Microorganisms Medicine-Microbiology (medical)

CiteScore

7.40

自引率

6.70%

发文量

2168

审稿时长

20.03 days

期刊介绍： Microorganisms (ISSN 2076-2607) is an international, peer-reviewed open access journal which provides an advanced forum for studies related to prokaryotic and eukaryotic microorganisms, viruses and prions. It publishes reviews, research papers and communications. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. There is no restriction on the length of the papers. The full experimental details must be provided so that the results can be reproduced. Electronic files and software regarding the full details of the calculation or experimental procedure, if unable to be published in a normal way, can be deposited as supplementary electronic material.

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