scholarly journals Most Nosocomial Pneumonias are Not Due to Nosocomial Bacteria in Ventilated Patients. Evaluation of the Accuracy of the 48 h Time Cut-off Using Carriage as the Gold Standard

2002 ◽  
Vol 30 (3) ◽  
pp. 275-282 ◽  
Author(s):  
L. Silvestri ◽  
R. E. Sarginson ◽  
J. Hughes ◽  
M. Milanese ◽  
D. Gregori ◽  
...  
Keyword(s):  
Predictive Value ◽  
Adult Population ◽  
Paediatric Population ◽  
Carrier State ◽  
Lower Airway ◽  
Airway Infections ◽  
The Difference ◽  
Sensitivity Specificity ◽  
Micro Organisms ◽  
Ventilated Patients

A prospective observational cohort study was undertaken with two endpoints: (1) to compare the time cut-off of 48h and the carrier state criterion for classifying lower airway infections in adult and paediatric long-term ventilated patients, and (2) to evaluate the potential of optimized time cut-offs for characterizing imported and ICU-acquired lower airway infections. All patients admitted to the general and paediatric intensive care units and expected to require mechanical ventilation for a period 3 days were enrolled. Surveillance cultures of throat and rectum were obtained on admission and thereafter twice weekly to distinguish micro-organisms that were imported into the unit from those acquired during the stay on the unit. A total of 130 adults and 400 children were studied. In the adult population, 70% of lower airway infections were classified as ICU-acquired by the 48 h cut-off and 48% by the criterion of carriage; on the paediatric ICU the percentages were 65% and 20%, respectively. To separate imported from ICU-acquired infections, eight days was optimal in the adult population and 10 days in the paediatric population. Sensitivity, specificity, positive predictive value and negative predictive value for a time cut-off of eight days for adults were 86, 77, 80, 83%, respectively, and using 10 days for children were 87, 62, 90, 56%, respectively. The use of the 48 h cut-off rule classifies patients as having nosocomial pneumonia, when in fact the infections are commonly caused by microorganisms carried in by the patients. In contrast, using the carriage method, the proportion of lung infections due to nosocomial bacteria was relatively small and was a late phenomenon. Although in prolonging the time cut-off the difference between the two types of classification was shorter, time cut-offs were still found to be unreliable for distinguishing imported from unit-acquired lower airway infections.

Evaluation of aseptic loosening of knee prostheses by quantitative bone scintigraphy

2008 ◽  
Vol 47 (04) ◽  
pp. 163-166 ◽  
Author(s):  
D. Steiner ◽  
S. Laurich ◽  
R. Bauer ◽  
J. Kordelle ◽  
R. Klett
Keyword(s):  
Aseptic Loosening ◽  
Bone Scintigraphy ◽  
Revision Surgery ◽  
Predictive Value ◽  
Knee Prostheses ◽  
Treatment Regimes ◽  
Golden Standard ◽  
The Difference ◽  
Sensitivity Specificity ◽  
Asymptomatic Control

SummaryIn not infected knee prostheses bone scintigraphy is a possible method to diagnose mechanical loosening, and therefore, to affect treatment regimes in symptomatic patients. However, hitherto studies showed controversial results for the reliability of bone scintigraphy in diagnosing loosened knee prostheses by using asymptomatic control groups. Therefore, the aim of our study was to optimize the interpretation procedure and to evaluate the accuracy using results from revision surgery as standard. Methods: Retrospectively, we were able to examine the tibial component in 31 cemented prostheses. In this prostheses infection was excluded by histological or bacteriological examination during revision surgery. To quantify bone scintigraphy, we used medial and lateral tibial regions with a reference region from the contralateral femur. Results: To differentiate between loosened and intact prostheses we found a threshold of 5.0 for the maximum tibia to femur ratio of the both tibial regions and a threshold of 18% for the difference of the ratio of both tibial regions. Using these thresholds, values of 0.9, 1, 0.85, 1, and 0.94 were calculated for sensitivity, specificity, negative predictive value, positive predictive value, and accuracy, respectively. To get a sensitivity of 1, we found a lower threshold of 3.3 for the maximum tibia to femur ratio. Conclusion: Quantitative bone scintigraphy appears to be a reliable diagnostic tool for aseptic loosening of knee prostheses with thresholds evaluated by revision surgery results being the golden standard.

Predictive significance of absolute lymphocyte count and morphology in adults with a new onset peripheral blood lymphocytosis

2014 ◽  
Vol 67 (12) ◽  
pp. 1062-1066 ◽  
Author(s):  
Ping Sun ◽  
Emilia M Kowalski ◽  
Calvino K Cheng ◽  
Allam Shawwa ◽  
Robert S Liwski ◽  
...  
Keyword(s):  
Predictive Value ◽  
Lymphocyte Count ◽  
Lymphoproliferative Disorder ◽  
Absolute Lymphocyte Count ◽  
Laboratory Evaluation ◽  
Characteristic Analysis ◽  
Reactive Process ◽  
The Difference ◽  
Sensitivity Specificity ◽  
Lymphocyte Number

AimsLymphocytosis is commonly encountered in the haematology laboratory. Evaluation of blood films is an important screening tool for differentiating between reactive and malignant processes. The optimal lymphocyte number to trigger morphological evaluation of the smear has not been well defined in the literature. Likewise, the significance of lymphocyte morphology has not been well studied and there are no consensus guidelines or follow-up recommendations available. We attempt to evaluate the significance of lymphocyte morphology and to define the best possible cut-off value of absolute lymphocyte count for morphology review.Methods71 adult patients with newly detected lymphocytosis of 5.0×109/L or more were categorised to either a reactive process or a lymphoproliferative disorder. We performed statistical analysis and morphology review to compare the difference in age, gender, lymphocyte count and morphological features between the two groups. Receiver operating characteristic analysis was performed to determine an optimal lymphocyte number to trigger morphology review.ResultsLymphoproliferative disorders are associated with advanced age and higher lymphocyte count. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of lymphocyte morphology as a screening test were 0.9, 0.59, 0.60, 0.58 and 0.71, respectively. The optimal cut-off of lymphocyte number for morphology review was found to be close to 7×109/L.ConclusionsWe found a moderate interobserver agreement for the morphological assessment. ‘Reactive’ morphology was very predictive of a reactive process, but ‘malignant’ morphology was a poor predictor of a lymphoproliferative disorder.

scholarly journals Computed tomography versus ureteroscopy in identification of renal tract stone with ureteral stent in situ

2011 ◽  
Vol 93 (8) ◽  
pp. 639-641 ◽  
Author(s):  
VCY Tang ◽  
A Attwell-Heap
Keyword(s):  
Computed Tomography ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Gold Standard ◽  
Ureteral Stent ◽  
The Difference ◽  
Contrast Ct ◽  
Sensitivity Specificity

INTRODUCTION The aim of this study was to validate the use of non-contrast computed tomography (CT) with a ureteral stent in situ instead of ureteroscopy for identification of renal tract stones. METHODS All patients who had stents inserted for renal tract stones and underwent non-contrast CT with the stent in situ followed by ureteroscopy between May 2008 and October 2009 at The Canberra Hospital, Australia, were analysed retrospectively. Statistical analysis was performed to compare any differences between CT and ureteroscopy in the identification of stones. RESULTS Overall, 57 patients were included in the study. The difference between CT and ureteroscopy findings was statistically significant. CT identification of stones with a stent in situ had a sensitivity of 86%, a specificity of 46%, a positive predictive value of 63%, a negative predictive value of 76% and an accuracy of 67%. CONCLUSIONS Our study suggests that non-contrast CT is inferior to the ‘gold standard’ of ureteroscopy. It lacks sensitivity, specificity, positive predictive value, negative predictive value and accuracy. Therefore, we cannot recommend using non-contrast CT to replace ureteroscopy.

scholarly journals Comparison of biparametric and multiparametric MRI in the diagnosis of prostate cancer

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Lili Xu ◽  
Gumuyang Zhang ◽  
Bing Shi ◽  
Yanhan Liu ◽  
Tingting Zou ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Area Under The Curve ◽  
Roc Curves ◽  
Multiparametric Mri ◽  
Dce Mri ◽  
Prostate Imaging ◽  
The Difference ◽  
Sensitivity Specificity

Abstract Purpose To compare the diagnostic accuracy of biparametric MRI (bpMRI) and multiparametric MRI (mpMRI) for prostate cancer (PCa) and clinically significant prostate cancer (csPCa) and to explore the application value of dynamic contrast-enhanced (DCE) MRI in prostate imaging. Methods and materials This study retrospectively enrolled 235 patients with suspected PCa in our hospital from January 2016 to December 2017, and all lesions were histopathologically confirmed. The lesions were scored according to the Prostate Imaging Reporting and Data System version 2 (PI-RADS V2). The bpMRI (T2-weighted imaging [T2WI], diffusion-weighted imaging [DWI]/apparent diffusion coefficient [ADC]) and mpMRI (T2WI, DWI/ADC and DCE) scores were recorded to plot the receiver operating characteristic (ROC) curves. The area under the curve (AUC), accuracy, sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) for each method were calculated and compared. The patients were further stratified according to bpMRI scores (bpMRI ≥3, and bpMRI = 3, 4, 5) to analyse the difference in DCE MRI between PCa and non-PCa lesions (as well as between csPCa and non-csPCa). Results The AUC values for the bpMRI and mpMRI protocols for PCa were comparable (0.790 [0.732–0.840] and 0.791 [0.733–0.841], respectively). The accuracy, sensitivity, specificity, PPV and NPV of bpMRI for PCa were 76.2, 79.5, 72.6, 75.8, and 76.6%, respectively, and the values for mpMRI were 77.4, 84.4, 69.9, 75.2, and 80.6%, respectively. The AUC values for the bpMRI and mpMRI protocols for the diagnosis of csPCa were similar (0.781 [0.722–0.832] and 0.779 [0.721–0.831], respectively). The accuracy, sensitivity, specificity, PPV and NPV of bpMRI for csPCa were 74.0, 83.8, 66.9, 64.8, and 85.0%, respectively; and 73.6, 87.9, 63.2, 63.2, and 87.8%, respectively, for mpMRI. For patients with bpMRI scores ≥3, positive DCE results were more common in PCa and csPCa lesions (both P = 0.001). Further stratification analysis showed that for patients with a bpMRI score = 4, PCa and csPCa lesions were more likely to have positive DCE results (P = 0.003 and P < 0.001, respectively). Conclusion The diagnostic accuracy of bpMRI is comparable with that of mpMRI in the detection of PCa and the identification of csPCa. DCE MRI is helpful in further identifying PCa and csPCa lesions in patients with bpMRI ≥3, especially bpMRI = 4, which may be conducive to achieving a more accurate PCa risk stratification. Rather than omitting DCE, we think further comprehensive studies are required for prostate MRI.

scholarly journals Absence of False Acetabulum is a Potent Indicator for Predicting the Use of Subtrochanteric Osteotomy in Total Hip Arthroplasty for High Dislocated Hips

2020 ◽  
Author(s):  
Jing-yang Sun ◽  
Guo-qiang Zhang ◽  
Yin-qiao Du ◽  
Jun-min Shen ◽  
Yong gang Zhou ◽  
...  
Keyword(s):  
Predictive Value ◽  
Statistical Significance ◽  
Roc Curves ◽  
Developmental Dysplasia ◽  
Greater Trochanter ◽  
Predictive Values ◽  
Type Iv ◽  
The Difference ◽  
Operative Notes ◽  
Sensitivity Specificity

Abstract Introduction: This study aimed to evaluate the predictive values of false acetabulum for assessment of whether to use subtrochanteric osteotomy.Materials and Methods: We retrospectively included a total of 182 patients (232 hips) affected by Crowe type IV developmental dysplasia who underwent primary THA with modular cementless stem from April 2008 to May 2019 in our institution. Based on radiographs and operative notes, we found 175 hips were performed with subtrochanteric osteotomy and 57 without subtrochanteric osteotomy, which was named (subtrochanteric osteotomy) STO group and non-STO group, respectively. The predictive values of absence of false acetabulum and distalization of greater trochanter were analyzed using receiver operating characteristic (ROC) curves.Results: ROC curves showed that absence of false acetabulum and distalization of greater trochanter had the AUCs of 0.957 and 0.987, respectively. And there was no statistical significance in the difference of these two AUCs (P=0.392). The optimal threshold for the distalization of greater trochanter was 4.83 cm, which resulted in a sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 92.6%, 100%, 100%, and 81.4%, respectively. For the absence of false acetabulum, the sensitivity, specificity, PPV, and NPV were 94.9%, 96.5%, 98.8%, and 85.9%, respectively.Conclusions: The absence of false acetabulum may be a potent indicator in predicting the use of subtrochanteric osteotomy in high dislocated hips.

scholarly journals Clinical Value of Three Combined Ultrasonography Modalities in Predicting the Risk of Metastasis to Axillary Lymph Nodes in Breast Invasive Ductal Carcinoma

2021 ◽  
Vol 11 ◽  
Author(s):  
Qing Zhang ◽  
Enock Adjei Agyekum ◽  
Linna Zhu ◽  
Lingling Yan ◽  
Lei Zhang ◽  
...  
Keyword(s):  
Lymph Node ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Ductal Carcinoma ◽  
Axillary Lymph ◽  
Clinical Value ◽  
Breast Invasive Ductal Carcinoma ◽  
The Difference ◽  
Sensitivity Specificity

ObjectiveThe present study aimed to assess the clinical value of conventional ultrasound (C-US), ultrasound elastography (UE), percutaneous contrast-enhanced ultrasound (P-CUES), and the combination of these three ultrasonography modalities for evaluating the risk of axillary lymph node (ALN) metastasis in breast invasive ductal carcinoma (IDC).MethodsThis retrospective analysis included 120 patients with pathologically confirmed IDC who underwent sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND). Based on the gold standard of postoperative pathology, ALN pathology results were evaluated and compared with findings obtained using C-US, UE, P-CUES, and the three modalities combined.Results(1) There was a statistically significant difference between the histological grade of the tumor and the pathological condition of ALNs. (2) The difference between C-US parameters and UE score were statistically significant. The accuracy of P-CEUS localization of SLNs was 100% (96/96) when compared with localization guided by methylene blue. The difference in the distribution of the four SLN enhancement patterns was statistically significant. (3) The sensitivity, specificity, positive predictive value, and negative predictive value of C-US and UE were 75%, 71%, 58%, and 89%, and 71%, 72%, 50%, and 86%, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of P-CUES were 91%, 82%, 78%, 92%, respectively. When all three modalities were combined, the sensitivity, specificity, positive predictive value, and negative predictive value were 94%, 89%, 86%, and 95%, respectively. In the detection of ALN metastasis, there was a good correlation between histopathological results and evaluations based on the three combined ultrasonography modalities (kappa: 0.82, p&lt;0.001).ConclusionsWhen compared to C-US, UE, or P-CEUS alone, the combination of the three ultrasonography modalities was found to be superior in distinguishing metastatic and non-metastatic ALNs. This combined strategy may aid physicians in determining the most appropriate approach to ALN surgery as well as the prognosis of breast IDC.

scholarly journals Forns index as a useful noninvasive predictor of esophageal varices in liver cirrhosis

2016 ◽  
Vol 35 (3) ◽  
pp. 199
Author(s):  
Rizqi Arini Siregar ◽  
Leonardo Basa Dairi ◽  
Gontar Alamsyah Siregar
Keyword(s):  
Esophageal Varices ◽  
Predictive Value ◽  
Cross Sectional Study ◽  
Serum Markers ◽  
Likelihood Ratios ◽  
Cross Sectional ◽  
Significant Difference ◽  
Cirrhotic Patients ◽  
The Difference ◽  
Sensitivity Specificity

Background<br />Rupture and bleeding from esophageal varices are major complications of portal hypertension and associated with a high mortality rate. Non-invasive serum markers of liver fibrosis could be used as predictors of esophageal varices in cirrhotic patients. The objective of this study was to assess the performance of Forns index as a noninvasive predictor in diagnosing esophageal varices.<br /><br />Methods<br />A cross-sectional study was done in 51 cirrhotic patients who were admitted to Adam Malik hospital, Medan. Demographic and clinical data were recorded and laboratory tests were performed, so that Forns index could be calculated. The difference between Forns index and size of esophageal varices as determined by endoscopy was tested by independent-t and Mann-Whitney analysis. The diagnostic performance was assessed using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, likelihood ratios and areas under the receiver operating characteristic curves (AUROC). <br /><br />Results<br />Of the 51 patients with esophageal varices included in this study, the size of esophageal varices comprised F2 (37.3%), F3 (33.3), and F1 (29.4%). Most patients were of Child-Plug C type (52.6%). There was a significant difference between Forns index and grade of esophageal varices. The AUROC for Forns index was 0.717 (95% CI: 0.561 - 0.872) and the cut-off &gt;7.92 was highly predictive to diagnose large esophageal varices with a sensitivity of 63.9%, specificity of 73.3%, PPV of 85.2%, NPV of 45.8% and accuracy of 71.7%.<br /><br />Conclusion<br />Forns index was significantly increased in large esophageal varices. Forns index is a good noninvasive predictor of esophageal varices in cirrhotic patients.

Using aorta lesion attenuation difference (ALAD) on preoperative contrast-enhanced CT scan to differentiate between malignant and benign renal tumors.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 606-606
Author(s):  
Joseph Grajo ◽  
Russell Terry ◽  
Justin Ruoss ◽  
Jonathan Pavlinec ◽  
Blake Noennig ◽  
...  
Keyword(s):  
Ct Scan ◽  
Predictive Value ◽  
Renal Tumors ◽  
Ct Scans ◽  
Discriminative Ability ◽  
Chromophobe Rcc ◽  
Contrast Enhanced Ct ◽  
Preoperative Ct ◽  
The Difference ◽  
Sensitivity Specificity

606 Background: To evaluate the ability of Aorta−Lesion−Attenuation−Difference (ALAD) to differentiate malignant renal tumors from renal oncocytomas. Methods: A retrospective review of preoperative CT scans and surgical pathology from robotic assisted partial nephrectomy specimens obtained by a single surgeon was performed. ALAD was calculated by measuring the difference in Hounsfield units (HU) between the aorta and the lesion of interest on the same image slice in the nephrographic phase on preoperative CT scan. The discriminative ability of ALAD to differentiate malignant pathology from oncocytoma was evaluated by sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under curve (AUC) using ROC analysis. Results: A total of 218 preoperative CT scans and corresponding pathology reports were reviewed. Pathology review revealed 22 oncocytomas (10.1%), 11 chromophobe RCC (5%), 37 papillary RCC (17%), and 148 clear cell RCC (67.9%). ALAD was able to differentiate malignant pathology from oncocytoma using a HU threshold of 24 with a sensitivity of 84%, specificity of 86%, PPV of 98%, and NPV of 33%. The AUC for malignant pathology versus oncocytoma was 0.86 (95% CI 0.77−0.96). Subgroup analysis showed that ALAD was able to differentiate chromophobe RCC from oncocytoma using a HU threshold of 24 with a sensitivity of 100%, specificity of 86%, PPV of 75%, and a NPV of 100%. The AUC for chromophobe RCC versus oncocytoma was 0.98 (95% CI 0.91−1.00). Conclusions: ALAD measurements based upon preoperative CT scans provide good discrimination between malignant renal tumors and oncocytomas, potentially decreasing the need for biopsy in certain patients. ALAD also discriminates well between chromophobe RCC and oncocytoma, which may aid in the management of patients with indeterminate diagnoses of oncocytic neoplasm on biopsy. Further validation of ALAD will be necessary prior to routine use in clinical practice.

scholarly journals PO 8496 ACCURACY OF DIAGNOSIS AND HAEMATOLOGICAL DIFFERENCE AMONG MALARIA PATIENTS IN RURAL AND URBAN AREAS IN THE ASHANTI REGION OF GHANA

2019 ◽  
Vol 4 (Suppl 3) ◽  
pp. A46.2-A46
Author(s):  
Abdul-Hakim Mutala ◽  
Kingsley Badu ◽  
Austine Tweneboah ◽  
Samul Agordzo ◽  
Dawood Ackom Abbas
Keyword(s):  
Parasite Density ◽  
Predictive Value ◽  
Urban Areas ◽  
High Specificity ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Rural And Urban Areas ◽  
Rural And Urban ◽  
The Difference ◽  
Sensitivity Specificity

BackgroundOver recent years, there has been an increase in the use of a histidine-rich protein 2(HRP-2)-based rapid diagnostic test (RDT) in the diagnosis of malaria. Accurate and prompt diagnosis of malaria will help reduce parasite reservoir and reduce malaria transmission. However, the underdiagnosis of malaria due to low parasite density hinders malaria eradication. The study aimed at establishing the baseline information on the accuracy of the HRP2-based RDT used in Ghana in three communities (Agona [rural], Kuntanase [peri-urban] and Kumasi [urban]) while determining the haematological difference among malaria patients.MethodsCross-sectional study was conducted from January to April 2018. A total of 304 participants were recruited in the study. Microscopy and RDT were used in the detection of malaria parasitaemia in all the samples.ResultsThe overall sensitivity, specificity, negative predictive value and positive predictive value was 75.9%, 95.6%, 64.7% and 97.4% respectively. The HRP-2 based RDT was highly sensitive (100%) for parasite density ≥250 parasite µl and relatively low for parasite density ≤100 parasite/µl (50%- Kumasi, 67%- Agona and 75%- Kuntanase). On the other hand, Agona (rural) recorded the highest prevalence (15.8%) followed by Kumasi (urban) (9%) and Kuntanase (peri-urban) being the lowest (6.8%). The difference in prevalence was however not statistically significant across the three communities. The rural area also accounted for highest parasite density (mean 99.53) and lowest in urban (60.29) with a statistical difference (p<0.001). The difference in white blood cell levels was significant (<0.0001) across Agona, Kuntanase and Kumasi. RBC and Hb levels were however not significant.ConclusionThe high specificity observed indicates that the majority of the patients without malaria were correctly diagnosed. Notwithstanding, the sensitivity was relatively low and below the WHO standard of ≥95% hence a significant number of malaria-positive cases were misdiagnosed. It is therefore important that the accuracy of RDT should be frequently assessed to improve its quality.

scholarly journals Different Diagnostic Performance of Fibrinogen and D-Dimer in Periprosthetic Joint Infection: A Propensity Score Matched Study

2021 ◽  
Author(s):  
Xi Chen ◽  
Wenwei Qian ◽  
Xisheng Weng ◽  
Jin Lin ◽  
Jin Jin ◽  
...  
Keyword(s):  
Propensity Score ◽  
Predictive Value ◽  
Diagnostic Performance ◽  
Joint Infection ◽  
Diagnostic Value ◽  
Optimal Threshold ◽  
Operating Characteristics ◽  
The Difference ◽  
Sensitivity Specificity ◽  
D Dimer

Abstract Background: Fibrinogen(Fbg) and D-dimer were introduced as biomarkers for the diagnosis of PJI. However, previous researches have reported controversial outcome on the diagnostic value of D-dimer in comparison to Fbg, CRP and ESR.Aim: This study aims to: 1.Determine the optimal threshold of plasma Fbg and D-dimer in the diagnosis of PJI and compare their diagnostic value to that of CRP and ESR. 2.Investigate if Fbg and D-dimer performs differently than CRP and ESR in different types of PJI.Methods: 115 revision cases after total hip arthroplasty(THA) and total knee arthroplasty(TKA) were identified. 30 PJI cases were matched to 60 Aseptic cases based on demographic characteristics using propensity score matching. Sensitivity, Specificity, Receiver operating characteristics(ROC), Negative predictive value(NPV) and Positive predictive value(PPV) were calculated and compared.Results: The optimal threshold is 1.69 mg/L for D-dimer and 3.655g/L for Fbg. Plasma Fbg, D-dimer, CRP and ESR were significantly higher in the PJI group than the Aseptic group. Fbg, D-dimer, CRP and ESR showed sensitivity of 0.83, 0.67, 0.83 and 0.8 respectively and showed specificity of 0.87, 0.77, 0.92 and 0.82 respectively. ROC curve showed that CRP has the highest AUC(0.90), followed by Fbg(0.89), ESR(0.88) and D-dimer(0.77).Conclusion: Plasma Fbg exhibited similar diagnostic performance comparing to CRP and ESR. Plasma D-dimer is of limited diagnostic value. In our study, Fbg and D-dimer did not show better diagnostic performance in any subtypes of PJI. Further studies are required to investigate the difference between serum D-dimer and plasma D-dimer in arthroplasty population.

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