scholarly journals Alpha defensin, leukocyte esterase, C-reactive protein, and leukocyte count in synovial fluid for pre-operative diagnosis of periprosthetic infection

2018 ◽  
Vol 32 ◽  
pp. 205873841880607 ◽  
Author(s):  
Elena De Vecchi ◽  
Carlo Luca Romanò ◽  
Roberta De Grandi ◽  
Laura Cappelletti ◽  
Francesca Villa ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Leukocyte Count ◽  
Joint Infection ◽  
Roc Curves ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Prosthetic Joint ◽  
Synovial Fluids ◽  
Leukocyte Counts

Synovial fluid analysis for diagnosis of prosthetic joint infections has gained increasing interest in the recent past when markers more specific for these infections than the serum ones have been identified. Despite the important steps forward, identification of a gold standard has not yet been identified. In this study, usefulness of alpha defensin, leukocyte esterase, C-reactive protein (CRP), and white blood cells (WBCs) in synovial fluids alone and in combination for diagnosis of prosthetic joint infection was evaluated. Synovial fluids from 32 infected and 34 not infected patients were analyzed. Sensitivity, specificity, positive and negative predictive values, diagnostic accuracy, and receiver-operating characteristic (ROC) curves were calculated for each parameter. Moreover, combination of coupled variables was also evaluated by logistic regression analysis. Sensitivity of alpha defensin, CRP, leukocyte count, and leukocyte esterase were 84.4%, 87.5%, 93.7%, and 93.8%, respectively. Specificity was 91.2% for leukocyte counts, 94.1% for alpha defensin, 97.0% for CRP, and 97.1% for leukocyte esterase. Diagnostic accuracy was 89.4% for alpha defensin, 92.4% for WBC counts and CRP, and 95.5% for leukocyte esterase. No statistical differences were observed in area under the curve (AUC) of the ROC curves of alpha defensin, CRP, and leukocyte counts. Logistic regression analysis applied to a model comprising all the variables showed an AUC higher than AUC of coupled variables. In conclusion, results of this study confirm the high sensitivity and specificity of synovial leukocyte esterase for diagnosis of prosthetic joint infection, also suggesting the need to assess a panel of markers to optimize diagnosis of these infections.

scholarly journals A novel procalcitonin-based score for detecting sepsis among critically ill patients

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245748
Author(s):  
Tung-Lin Tsui ◽  
Ya-Ting Huang ◽  
Wei-Chih Kan ◽  
Mao-Sheng Huang ◽  
Min-Yu Lai ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Validation Cohort ◽  
Multivariate Logistic Regression Analysis ◽  
Sepsis Group ◽  
C Reactive Protein ◽  
Multivariate Logistic Regression ◽  
Reactive Protein

Background Procalcitonin (PCT) has been widely investigated as an infection biomarker. The study aimed to prove that serum PCT, combining with other relevant variables, has an even better sepsis-detecting ability in critically ill patients. Methods We conducted a retrospective cohort study in a regional teaching hospital enrolling eligible patients admitted to intensive care units (ICU) between July 1, 2016, and December 31, 2016, and followed them until March 31, 2017. The primary outcome measurement was the occurrence of sepsis. We used multivariate logistic regression analysis to determine the independent factors for sepsis and constructed a novel PCT-based score containing these factors. The area under the receiver operating characteristics curve (AUROC) was applied to evaluate sepsis-detecting abilities. Finally, we validated the score using a validation cohort. Results A total of 258 critically ill patients (70.9±16.3 years; 55.4% man) were enrolled in the derivation cohort and further subgrouped into the sepsis group (n = 115) and the non-sepsis group (n = 143). By using the multivariate logistic regression analysis, we disclosed five independent factors for detecting sepsis, namely, “serum PCT level,” “albumin level” and “neutrophil-lymphocyte ratio” at ICU admission, along with “diabetes mellitus,” and “with vasopressor.” We subsequently constructed a PCT-based score containing the five weighted factors. The PCT-based score performed well in detecting sepsis with the cut-points of 8 points (AUROC 0.80; 95% confidence interval (CI) 0.74–0.85; sensitivity 0.70; specificity 0.76), which was better than PCT alone, C-reactive protein and infection probability score. The findings were confirmed using an independent validation cohort (n = 72, 69.2±16.7 years, 62.5% men) (cut-point: 8 points; AUROC, 0.79; 95% CI 0.69–0.90; sensitivity 0.64; specificity 0.87). Conclusions We proposed a novel PCT-based score that performs better in detecting sepsis than serum PCT levels alone, C-reactive protein, and infection probability score.

scholarly journals Assessment of a Multiplex Serological Test for the Diagnosis of Prosthetic Joint Infection: a Prospective Multicentre Study

2020 ◽  
Vol 5 (2) ◽  
pp. 89-95 ◽  
Author(s):  
Pascale Bémer ◽  
Céline Bourigault ◽  
Anne Jolivet-Gougeon ◽  
Chloé Plouzeau-Jayle ◽  
Carole Lemarie ◽  
...  
Keyword(s):  
Negative Predictive Value ◽  
Predictive Value ◽  
Serological Test ◽  
Bacterial Species ◽  
Joint Infection ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Cutibacterium Acnes

Abstract. Introduction: The diagnosis of prosthetic joint infections (PJIs) can be difficult in the chronic stage and is based on clinical and paraclinical evidence. A minimally invasive serological test against the main pathogens encountered during PJI would distinguish PJI from mechanical loosening.Methods: We performed a prospective, multicentre, cross-sectional study to assess the contribution of serology in the diagnosis of PJI. Over a 2-year period, all patients undergoing prosthesis revision were included in the study. A C-reactive protein assay and a serological test specifically designed against 5 bacterial species (Staphylococcus aureus, S. epidermidis, S. lugdunensis, Streptococcus agalactiae, Cutibacterium acnes) were performed preoperatively. Five samples per patient were taken intraoperatively during surgery. The diagnosis of PJI was based on clinical and bacteriological criteria according to guidelines.Results: Between November 2015 and November 2017, 115 patients were included, 49 for a chronic PJI and 66 for a mechanical problem. Among patients with PJI, a sinus tract was observed in 32.6% and a C-reactive protein level ≥10 mg/L in 74.5%. The PJI was monomicrobial in 43 cases (targeted staphylococci, 24; S. agalactiae, 1; C. acnes, 2; others, 16), and polymicrobial in 6 cases (12.2%). Sensitivity, specificity, positive predictive value and negative predictive value were 75.0%, 82.1%, 58.3% and 90.8%, respectively, for targeted staphylococci. Specificity/negative predictive value was 97.3%/100% for S. agalactiae and 83.8% /96.9% for C. acnes.Conclusions: The serological tests are insufficient to affirm the diagnosis of PJI for the targeted bacteria. Nevertheless, the excellent NPV may help clinicians to exclude PJI.

The Kidney, Liver, Index surgery and C reactive protein score is a predictor of treatment response in acute prosthetic joint infection

2017 ◽  
Vol 42 (1) ◽  
pp. 33-38 ◽  
Author(s):  
C Jiménez-Garrido ◽  
J M Gómez-Palomo ◽  
I Rodriguez-Delourme ◽  
F J Durán-Garrido ◽  
E Nuño-Álvarez ◽  
...  
Keyword(s):  
Treatment Response ◽  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Liver Index ◽  
Prosthetic Joint ◽  
Kidney Liver

scholarly journals Role of clinical and biochemical inflammation in structural progression of patients with psoriatic arthritis

RMD Open ◽  
2021 ◽  
Vol 7 (3) ◽  
pp. e002038
Author(s):  
Carina Borst ◽  
Farideh Alasti ◽  
Josef S Smolen ◽  
Daniel Aletaha
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Psoriatic Arthritis ◽  
Radiographic Progression ◽  
Controlled Trial ◽  
The Other ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Structural Progression

ObjectiveTo determine the contribution of clinical and biochemical inflammation to structural progression of patients with psoriatic arthritis (PsA).MethodsWe analysed patients from the Infliximab Multinational Psoriatic Arthritis Controlled Trial 2 trial (infliximab vs placebo). We obtained total modified Sharp/van-der-Heijde Scores from baseline and year one images, and swollen joint counts (SJC) and levels of C reactive protein (CRP) throughout the second half of year 1 (5 measurements) from 74 placebo-treated patients. We computed radiographic progression, time-averaged SJC (taSJC) and CRP (taCRP) values and assessed their impact on structural progression by logistic regression analysis. We further categorised patients as ‘active’ (+) or ‘inactive’ (−) based on their taSJC (cut-off point: 2/66 joints) and taCRP (cut-off point: 0.5 mg/dL) and compared radiographic progression across three groups (double inactive, single active, double active).ResultsORs for progression were 1.24 (95 % CI 1.04 to 1.47; p=0.016) for taSJC and 6.08 (95 % CI 1.12 to 33.03; p=0.036) for taCRP. When predictors were dichotomised (+ vs −), differences were maintained between taSJC+ and taSJC− patients (1.05±3.21 and 0.56±2.30, respectively), as well as for taCRP+ vs taCRP− patients (1.14±3.23 and 0.05±2.37, respectively). Progression was intermediate in the presence of abnormalities of one but not the other inflammatory variable, indicating increasing radiographic progression with increasing inflammation (p=0.05).ConclusionIn patients with PsA, both clinical and biochemical inflammation have an impact on structural progression. Overall, progression is smallest in the absence of both clinical and biochemical inflammation, higher when either clinical or biochemical inflammation is present and highest with both clinical and biochemical inflammation.

scholarly journals ESM-1 Levels and ARDS Prediction Score for Predicting ARDS Occurrence in Sepsis Patients

2020 ◽  
Author(s):  
Xuebin Wang ◽  
Ting Dong ◽  
Huan Yang ◽  
Xuan Ju ◽  
Haiyan Ye
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Pearson Correlation ◽  
Characteristic Curve ◽  
Roc Curves ◽  
Prediction Score ◽  
Predictive Score ◽  
Retrospective Case ◽  
Reactive Protein

Abstract Background: Acute respiratory distress syndrome (ARDS) development is overtly associated with elevated mortality. This study aimed to determine the parameters predicting ARDS in sepsis patients. Methods: This was a retrospective case control study. The sepsis patients admitted to the intensive care unit were divided into the ARDS and non-ARDS groups according to ARDS occurrence within 72 hours. Plasma endothelial cell specific molecule-1 (ESM-1), white blood cell (WBC), C-reactive protein (CRP), interleukin-6 (IL-6) and procalcitonin (PCT) were assessed on the first day. PaO2/FiO2 ratio was determined on the first two days. Pearson correlation analysis and logistic regression analysis were carried out. Results: The ARDS and non-ARDS groups included 12 and 42 patients respectively. ESM-1 levels in the ARDS group on the first day were significantly lower than those of the non-ARDS group (P=0.009). ESM-1 levels and PaO2/FiO2 ratio were positively correlated. Logistic regression analysis showed that ESM-1, CRP and IL-6 levels on the first day were associated with ARDS. The areas under the receiver operating characteristic curve (ROC) curves (AUCs) for ESM-1, CRP and IL-6 were 0.750, 0.736 and 0.736, respectively. A regression equation was established based on the coefficients of plasma ESM-1, CRP and IL-6 levels to derive an ARDS prediction score with an AUC for predicting ARDS of 0.895.Conclusion: Plasma ESM-1, CRP and IL-6 levels on the first day are associated with ARDS in sepsis. The novel ARDS predictive score is obviously better than ESM-1, CRP and IL-6 in predicting ARDS in sepsis patients.

Increased pretreatment C-reactive protein-to-albumin ratio predicts severe coronavirus disease 2019

2020 ◽  
Author(s):  
Xiaoyue Wang ◽  
Yan Xu ◽  
Huang Huang ◽  
Desheng Jiang ◽  
Chunlei Zhou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Early Warning ◽  
Warning Signs ◽  
C Reactive Protein ◽  
Albumin Ratio ◽  
Reactive Protein ◽  
Independent Risk Factors

Abstract Objective The aim of this study was to identify early warning signs for severe coronavirus disease 2019 (COVID-19). Methods We retrospectively analysed the clinical data of 90 patients with COVID-19 from Guanggu District of Hubei Women and Children Medical and Healthcare Center, comprising 60 mild cases and 30 severe cases. The demographic data, underlying diseases, clinical manifestations and laboratory blood test results were compared between the two groups. The cutoff values were determined by receiver operating characteristic curve analysis. Logistic regression analysis was performed to identify the independent risk factors for severe COVID-19. Results The patients with mild and severe COVID-19 had significant differences in terms of cancer incidence, age, pretreatment neutrophil-to-lymphocyte ratio (NLR), and pretreatment C-reactive protein-to-albumin ratio (CAR) ( P =0.000; P =0.008; P=0.000; P =0.000). The severity of COVID-19 was positively correlated with comorbid cancer, age, NLR, and CAR ( P <0.005). Multivariate logistic regression analysis showed that age, the NLR and the CAR were independent risk factors for severe COVID-19 (OR=1.086, P =0.008; OR=1.512, P =0.007; OR=17.652, P =0.001). Conclusion An increased CAR can serve as an early warning sign of severe COVID-19 in conjunction with the NLR and age.

An increased pretreatment C-reactive protein-to-albumin ratio predicts severe novel coronavirus-infected pneumonia

2020 ◽  
Author(s):  
Xiaoyue Wang ◽  
Yan Xu ◽  
Huang Huang ◽  
Desheng Jiang ◽  
Chunlei Zhou ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Early Warning ◽  
Multivariate Logistic Regression Analysis ◽  
Warning Signs ◽  
C Reactive Protein ◽  
Albumin Ratio ◽  
Reactive Protein ◽  
Novel Coronavirus

Abstract Objective The aim of this study was to identify early warning signs for severe novel coronavirus-infected pneumonia (COVID-19). Methods We retrospectively analyzed the clinical data of 90 patients with COVID-19 from Guanggu District of Hubei Women and Children Medical and Healthcare Center comprising 60 mild cases and 30 severe cases. The demographic data, underlying diseases, clinical manifestations and laboratory blood test results were compared between the two groups. The cutoff values was determined by receiver operating characteristic curve analysis. Logistic regression analysis was performed to identify the independent risk factor that predicted the severe COVID-19. Results The patients with mild and severe COVID-19 showed significant differences in terms of cancer incidence, age, pretreatment neutrophil-to-lymphocyte ratio (NLR), and pretreatment C-reactive protein-to-albumin ratio (CAR) (P < 0.05). The severity of COVID-19 was correlated positively with the comorbidity of cancer, age, NLR, and CAR (P < 0.05). Multivariate logistic regression analysis showed that age, NLR and CAR were independent risk factors for severe COVID-19 (OR = 1.086, P = 0.008; OR = 1.512, P = 0.007; OR = 17.652, P = 0.001, respectively). Conclusion An increased CAR can serve as an early warning sign of severe COVID-19 in conjunction with the NLR and age.

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