scholarly journals The Globulin, Albumin To Globulin Ratio(A/G) and Neutrophil To Lymphocyterate (NLR) Do Not Perform Better Than CRP and ESR in PJI Diagnosis

Author(s):  
Jing-bo Jiao ◽  
Jin-Cheng Huang ◽  
Xiao Chen ◽  
Yi Jin

Abstract Objective: To test the significance of serum C-reactive protein (CRP), the erythrocyte sedimentation rate (ESR), globulin(GLN) ,albumin to globulin ratio(A/G), and neutrophil to lymphocyterate(NLR) in periprosthetic joint infection (PJI) diagnosis. Methods: We retrospectively analyzed the clinical data of 115 patients diagnosed from January 2017 to December 2020 with PJI (PJI group, median age 71.00 years [range, 41-94 years], 24 males, 29 females), and aseptic loosening (aseptic group, median age 68.50 years [range, 34–85 years], 32 male, 30 female) in our department. Demographic data and thesensitivity and specificity of preoperative CRP, ESR, GLB,A/G, and NLR in PJI diagnosis were compared. Results: There were no significant differences when the demographic data of the two groups were compared. The expression level of CRP (24.89 mg/L([IQR], 0.1 to 200)), ESR (3 mm/h([IQR], 6 to 120)), GLB (31.70 g/L ( [IQR], 18.50 to 60.60)), and NLR (2.51([IQR], 0.93 to 12.23)) in the PJI group were higher than in the aseptic loosening group (CRP: 2.245 mg/L([IQR], 0.2 to 111.94);ESR: 16 mm/h ([IQR], 2 to 76); GLB: 26.60 g/L([IQR], 17.90 to 68.20); NLR: 1.85([IQR], 0.63 to 9.09)). The expression level of A/G (1.15([IQR], 0.55 to 2.16)) in the PJI group was lower than in the aseptic loosening group (1.51([IQR], 0.71 to 2.40)). Receiver operating characteristic (ROC) curve analysis demonstrated that the areas under the ROC curve (AUC) for CRP, ESR, GLB,A/G, and NLR were 0.841 (95% confidence interval, 0.761-0.903), 0.850 (0.771-0.910),0.747(0.658-0.824),0.779(0.692–0.851), and 0.708 (0.616–0.789), respectively. When GLB > 26.6g/L, A/G <1.32, and NLR >2.1 were set as the threshold values for the diagnosis of PJI, The sensitivity of GLB and A/G (90.57%, 81.13%) is higher than CRP (71.70%) and ESR (79.25%), but the specificity (GLB: 51.61%, A/G: 72.58%) was significantly lower than of CRP (87.10%) and ESR (75.81%). The ROC analysis of NLR showed that its sensitivity (73.58%) and specificity (70.97) had no significant advantages over CRP and ESR. Conclusion: globulin, A/G and NLR do not perform better than CRP and ESR in PJI diagnosis.

2021 ◽  
Author(s):  
JingBo Jiao ◽  
Jin-cheng Huang ◽  
Xiao Chen ◽  
Yi Jin

Abstract Objective: To test the significance of serum C-reactive protein (CRP), the erythrocyte sedimentation rate (ESR), globulin(GLN) , albumin to globulin ratio (A/G), and neutrophil to lymphocyterate (NLR) in periprosthetic joint infection (PJI) diagnosis. Methods: We retrospectively analyzed the clinical data of 115 patients diagnosed from January 2017 to December 2020 with PJI (PJI group, median age 71.00 years [range, 41-94 years], 24 males, 29 females), and aseptic loosening (aseptic group, median age 68.50 years [range, 34–85 years], 32 male, 30 female) in our department. Demographic data and thesensitivity and specificity of preoperative CRP, ESR, GLB,A/G, and NLR in PJI diagnosis were compared. Results: There were no significant differences when the demographic data of the two groups were compared. The expression level of CRP (24.89 mg/L([IQR], 0.1 to 200)), ESR (3 mm/h([IQR], 6 to 120)), GLB (31.70 g/L ( [IQR], 18.50 to 60.60)), and NLR (2.51([IQR], 0.93 to 12.23)) in the PJI group were higher than in the aseptic loosening group (CRP: 2.245 mg/L([IQR], 0.2 to 111.94);ESR: 16 mm/h ([IQR], 2 to 76); GLB: 26.60 g/L([IQR], 17.90 to 68.20); NLR: 1.85([IQR], 0.63 to 9.09)). The expression level of A/G (1.15([IQR], 0.55 to 2.16)) in the PJI group was lower than in the aseptic loosening group (1.51([IQR], 0.71 to 2.40)). Receiver operating characteristic (ROC) curve analysis demonstrated that the areas under the ROC curve (AUC) for CRP, ESR, GLB,A/G, and NLR were 0.841 (95% confidence interval, 0.761-0.903), 0.850 (0.771-0.910),0.747(0.658-0.824),0.779(0.692–0.851), and 0.708 (0.616–0.789), respectively. When GLB > 26.6g/L, A/G <1.32, and NLR >2.1 were set as the threshold values for the diagnosis of PJI, The sensitivity of GLB and A/G (90.57%, 81.13%) is higher than CRP (71.70%) and ESR (79.25%), but the specificity (GLB: 51.61%, A/G: 72.58%) was significantly lower than of CRP (87.10%) and ESR (75.81%). The ROC analysis of NLR showed that its sensitivity (73.58%) and specificity (70.97) had no significant advantages over CRP and ESR. Conclusion: globulin, A/G and NLR do not perform better than CRP and ESR in PJI diagnos is.


2009 ◽  
Vol 27 (23) ◽  
pp. 3849-3854 ◽  
Author(s):  
Rodrigo D. Portugal ◽  
Marcia Garnica ◽  
Marcio Nucci

Purpose Patients with prolonged and profound neutropenia are at high risk to develop invasive mold infections (IMIs). We developed an index (D-index) that combines duration and severity of neutropenia. The aim of this study was to test the D-index as a predictor of IMI. Patients and Methods The D-index was based on a graph plotting the absolute neutrophil counts during neutropenia and was the area over the neutrophil curve. We tested the D-index in 11 patients with acute myeloid leukemia (AML) who developed IMI during neutropenia and 33 AML patients without IMI (controls). We also calculated a cumulative D-index (c-D-index), defined as the cumulative D-index from the start of neutropenia until the date of the first clinical manifestation of IMI in patient cases. We compared the D-index and c-D-index with duration of neutropenia and defined a cutoff for IMI using the receiver operating characteristic (ROC) curve. Results The median duration of neutropenia and profound neutropenia of patient cases were significantly higher compared with controls (P = .002 and P = .001, respectively), as were the D-index (P < .001) and c-D-index (P = .02). The D-index and c-D-index performed better than duration of neutropenia in ROC curve analysis. For a cutoff point of 5,800 of the c-D-index, the sensitivity and specificity were 91% and 58%, respectively, and for a prevalence of IMI of 5%, 10%, and 15%, the negative predictive values were 99%, 98%, and 97%, respectively. Conclusion The high negative predictive value of the c-D-index may be of help in defining different risks for IMI in febrile neutropenic patients.


2021 ◽  
Author(s):  
Guanghui Zhou ◽  
Yi Shan ◽  
Zhiwei Tang ◽  
Ruhua Chen ◽  
Yan Fen ◽  
...  

Abstract Background We aimed to evaluate the diagnostic value of Activin A levels in serum and pleural effusion on parapneumonic pleural effusion (PPE). Methods We collected serum and pleural effusion from 86 PPE and 37 non-PPE (NPPE) patients. Including Activin A, levels of biomarkers as lactate dehydrogenase (LDH), procalcitonin (PCT) and C-reactive protein (CRP) were measured. All factors were calculated for association with days after admission. The diagnostic potential of biomarkers on PPE was considered by receiver operating characteristic (ROC) curve analysis. Results Levels of Activin A in serum and pleural effusion of PPE patients were significantly higher than those of the NPPE patients. Moreover, concentrations of Activin A in pleural effusion showed a more obvious relevant days after admission. ROC curve analysis found that Activin A in pleural effusion had AUCs of 0.899 with 93% sensitivity and 84% specificity for PPE diagnosis. Conclusion Activin A in pleural effusion correlated with disease severity could act to diagnosis PPE.


2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Yuichiro Shimoyama ◽  
Osamu Umegaki ◽  
Noriko Kadono ◽  
Toshiaki Minami

Abstract Objective Sepsis is a major cause of mortality for critically ill patients. This study aimed to determine whether presepsin values can predict mortality in patients with sepsis. Results Receiver operating characteristic (ROC) curve analysis, Log-rank test, and multivariate analysis identified presepsin values and Prognostic Nutritional Index as predictors of mortality in sepsis patients. Presepsin value on Day 1 was a predictor of early mortality, i.e., death within 7 days of ICU admission; ROC curve analysis revealed an AUC of 0.84, sensitivity of 89%, and specificity of 77%; and multivariate analysis showed an OR of 1.0007, with a 95%CI of 1.0001–1.0013 (p = 0.0320).


2021 ◽  
Author(s):  
Javid Azadbakht ◽  
Sina Rashedi ◽  
Soheil Kooraki ◽  
Hamed Kowsari ◽  
Elnaz Tabibian

Abstract Objectives We aimed to develop and validate a prognostic model to predict clinical deterioration defined as either death or intensive care unit admission of hospitalized COVID-19 patients.Methods This prospective, multicenter study investigated 172 consecutive hospitalized COVID-19 patients who underwent a chest computed tomography (CT) scan between March 20 and April 30, 2020 (development cohort), as well as an independent sample of 40 consecutive patients for external validation (validation cohort). The clinical, laboratory, and radiologic data were gathered, and logistic regression along with receiver operating characteristic (ROC) curve analysis was performed.Results The overall clinical deterioration rates of the development and validation cohorts were 28.4% (49 of 172) and 30% (12 of 40), respectively. Seven predictors were included in the scoring system with a total score of 15: CT severity score\(\ge\)15 (Odds Ratio (OR)=6.34, 4 points), pleural effusion (OR = 6.80, 2 points), symptom onset to admission ≤ 6 days (OR = 2.44, 2 points), age\(\ge\)70 years (OR = 2.44, 2 points), diabetes mellitus (OR = 2.24, 2 points), dyspnea (OR = 2.17, 1.5 points), and abnormal leukocyte count (OR = 1.89, 1.5 points). The area under the ROC curve for the scoring system in the development and validation cohorts was 0.823 (CI [0.751–0.895]) and 0.558 (CI [0.340–0.775]), respectively.Conclusion This study provided a new easy-to-calculate scoring system with external validation for hospitalized COVID-19 patients to predict clinical deterioration based on a combination of seven clinical, laboratory, and radiologic parameters.


2021 ◽  
Author(s):  
Naoya Fujita ◽  
Yosuke Ono ◽  
Azusa Sano ◽  
Motohiro Kimata ◽  
Seigo Oyama ◽  
...  

Objective: Conventional diagnostic methods are limited in their ability to differentiate destructive thyroiditis from Graves’ disease. We hypothesised that serum diiodotyrosine (DIT) and monoiodotyrosine (MIT) levels could be biomarkers for differentiating destructive thyroiditis from Graves’ disease. Design: Patients with destructive thyroiditis (n = 13) and Graves’ disease (n = 22) were enrolled in this cross-sectional study. Methods: We assayed the serum DIT and MIT levels using liquid chromatography-tandem mass spectrometry. A receiver operating characteristic (ROC) curve analysis was used to determine the sensitivity and specificity of the serum DIT and MIT levels as biomarkers for differentiating destructive thyroiditis from Graves’ disease. Results: The serum DIT and MIT levels were significantly higher in patients with destructive thyroiditis than in those with Graves’ disease. The ROC curve analysis showed that the serum DIT levels (≥ 359.9 pg/mL) differentiated destructive thyroiditis from Graves’ disease, significantly, with 100.0% sensitivity and 95.5% specificity (P < .001). The diagnostic accuracy of the serum MIT levels (≥119.4 pg/mL) was not as high as that of the serum DIT levels (sensitivity, 84.6%; specificity, 77.3%; P = .001). Conclusions: The serum DIT levels may serve as a novel diagnostic biomarker for differentiating destructive thyroiditis from Graves’ disease.


2019 ◽  
Vol 185 (2) ◽  
pp. 52-52 ◽  
Author(s):  
Francesca Perondi ◽  
Ilaria Lippi ◽  
Gianila Ceccherini ◽  
Veronica Marchetti ◽  
Grazia Guidi

Urinary and blood biomarkers for diagnosis of acute kidney injury (AKI) in hospitalised dogs were evalueted. This prospective study included 97 dogs, classified according to the International Renal Interest Society classification into no AKI and AKI grade 1 (48-hour increase in serum creatinine≥0.3 mg/dl and/or urinary production <1 ml/kg/hour for at least six hours). A total of 62 of 97 dogs (64 per cent) were classified as AKI 1. A statistically significant difference was found between no AKI and AKI 1 in urine protein to creatinine ratio, urinary γ-glutamyl transferase (uGGT) and uGGT/cu (P<0.0001). Thirteen of 97 dogs (13.4 per cent) that developed increased creatinine and change in AKI grade showed high mortality (n=9/13; 69.2 per cent). The receiver operating characteristic (ROC) curve analysis of uGGT/cu index as a marker for AKI grade 1 had an area under the ROC curve of 0.78; optimal cut-off point was 57.50 u/g, with sensitivity and specificity of 75.4 per cent and 75.6 per cent, respectively. Overall intensive care unit mortality was 23.7 per cent (23/97), 13.4 per cent (13/97) of which died during hospitalisation and 10.3 per cent (10/97) within 28 days after discharge. uGGT is an acceptable marker for distinguishing between AKI 1 and no AKI.


2020 ◽  
Vol 18 ◽  
pp. 205873922094234
Author(s):  
Heng Xue ◽  
Hui Liu ◽  
Liangpu Xu ◽  
Qiaoling Liu ◽  
Bimin Zhuo ◽  
...  

The aim of this study was to investigate the predictive value of peptidyl-prolyl cis-trans isomerase NIMA-interacting 1 (Pin1) with C-reactive protein (CRP) and white blood cell (WBC) count for community-acquired pneumonia (CAP) in infants. A total of 84 hospitalized infants with CAP and 69 healthy infants were included in this study. The clinical manifestations and laboratory assay results of infants were recorded. Serum Pin1 level was estimated by enzyme-linked immunosorbent assay. The median serum Pin1 concentration in infants with CAP was significantly higher than that in controls (1.44 vs. 0.21 ng/mL, P < 0.0001). Receiver operating characteristic (ROC) curve analysis showed that the area under the ROC curve (AUC) of the combination Pin1, CRP and WBC (Pin1 + CRP + WBC, 0.943) was higher than Pin1, CRP, WBC alone or the combination of Pin1 and CRP ( P < 0.05). The sensitivity of Pin1 + CRP + WBC (94.0%) was higher than that of Pin1, CRP, WBC alone, or any two combined ( P < 0.05). Pin1 + CRP + WBC also had a high negative predictive value (91.4%). Moreover, serum Pin1 alone had a high specificity (97.0%) and excellent positive predictive value (96.6%) for infants with CAP, which were higher than WBC, Pin1 and WBC in combination, CRP and WBC in combination, and Pin1 + CRP + WBC ( P < 0.05). Therefore, serum Pin 1 was highly expressed in infants with CAP and can singly or in combination with CRP and WBC represent promising novel predictors for infants with CAP.


Author(s):  
Hanaa H. Ahmed ◽  
Wafaa Gh Shousha ◽  
Hatem A El Mezayen ◽  
Ibrahim A Emara ◽  
Marwa E Hassan

  Objective: This work was delineated to assess procalcitonin (PCT) and C-reactive protein (CRP) as prognostic markers for cardiovascular complication in type 2 diabetic patients.Methods: Forty diabetic patients without cardiovascular disease (CVD), 40 diabetic patients with CVD, and 20 healthy control counterparts were participated in this study. Serum PCT and CRP levels were assayed and correlated with metabolic parameters. Receiver operating characteristic (ROC) curve analysis was done for each biochemical marker.Results: The mean level of PCT was 707.17±99.19 ng/l in diabetic patients versus 881.30±123.56 ng/l for the cardio-diabetic patients (p<0.0001). The mean value of CRP was 34.43±17.27 mg/l in diabetic patients versus 50.32±20.19 mg/l for the cardio-diabetic patients (p=0.0003). PCT levels were significantly amplified in the cardio-diabetic patients with increasing CRP, triglycerides (TG), fasting blood glucose (FBG), and cholesterol (p=0.004, 0.0005, 0.002, and 0.01, respectively). CRP levels were significantly enhanced in the cardio-diabetic patients with increasing TG, FBG, cholesterol, and microalbumin (p=0.002, 0.047, 0.003, and 0.001 respectively). ROC curve analysis for PCT and CRP revealed that the area under curve (AUC) was 0.878 and 0.727, respectively. These findings indicate the good validity of the above biomarkers especially PCT as a prognostic marker for cardiovascular complication in type 2 diabetic patients.Conclusion: This study evidences the usefulness of measuring serum levels of PCT and CRP in diagnosis of cardiovascular complication in type 2 diabetic patients.


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