Predicting the Exception—CRP and Primary Hip Arthroplasty
2021 | journal article; research paper. A publication with affiliation to the University of Göttingen.
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Predicting the Exception—CRP and Primary Hip Arthroplasty
Meier, M.-P.; Bauer, I. J.; Maheshwari, A. K.; Husen, M.; Jäckle, K.; Hubert, J. & Hawellek, T. et al. (2021)
Journal of Clinical Medicine, 10(21) pp. 4985. DOI: https://doi.org/10.3390/jcm10214985
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Details
- Authors
- Meier, Marc-Pascal; Bauer, Ina Juliana; Maheshwari, Arvind K.; Husen, Martin; Jäckle, Katharina; Hubert, Jan; Hawellek, Thelonius; Lehmann, Wolfgang; Saul, Dominik
- Abstract
- Background: While primary hip arthroplasty is the most common operative procedure in orthopedic surgery, a periprosthetic joint infection is its most severe complication. Early detection and prediction are crucial. In this study, we aimed to determine the value of postoperative C-reactive protein (CRP) and develop a formula to predict this rare, but devastating complication. Methods: We retrospectively evaluated 708 patients with primary hip arthroplasty. CRP, white blood cell count (WBC), and several patient characteristics were assessed for 20 days following the operative procedure. Results: Eight patients suffered an early acute periprosthetic infection. The maximum CRP predicted an infection with a sensitivity and specificity of 75% and 56.9%, respectively, while a binary logistic regression reached values of 75% and 80%. A multinominal logistic regression, however, was able to predict an early infection with a sensitivity and specificity of 87.5% and 78.9%. With a one-phase decay, 71.6% of the postoperative CRP-variance could be predicted. Conclusion: To predict early acute periprosthetic joint infection after primary hip arthroplasty, a multinominal logistic regression is the most promising approach. Including five parameters, an early infection can be predicted on day 5 after the operative procedure with 87.5% sensitivity, while it can be excluded with 78.9% specificity.
Background: While primary hip arthroplasty is the most common operative procedure in orthopedic surgery, a periprosthetic joint infection is its most severe complication. Early detection and prediction are crucial. In this study, we aimed to determine the value of postoperative C-reactive protein (CRP) and develop a formula to predict this rare, but devastating complication. Methods: We retrospectively evaluated 708 patients with primary hip arthroplasty. CRP, white blood cell count (WBC), and several patient characteristics were assessed for 20 days following the operative procedure. Results: Eight patients suffered an early acute periprosthetic infection. The maximum CRP predicted an infection with a sensitivity and specificity of 75% and 56.9%, respectively, while a binary logistic regression reached values of 75% and 80%. A multinominal logistic regression, however, was able to predict an early infection with a sensitivity and specificity of 87.5% and 78.9%. With a one-phase decay, 71.6% of the postoperative CRP-variance could be predicted. Conclusion: To predict early acute periprosthetic joint infection after primary hip arthroplasty, a multinominal logistic regression is the most promising approach. Including five parameters, an early infection can be predicted on day 5 after the operative procedure with 87.5% sensitivity, while it can be excluded with 78.9% specificity. - Issue Date
- 2021
- Journal
- Journal of Clinical Medicine
- Organization
- Klinik für Unfallchirurgie, Orthopädie und Plastische Chirurgie
- eISSN
- 2077-0383
- Language
- English
- Sponsor
- Open-Access-Publikationsfonds 2021