Complete blood platelet and lymphocyte ratios increase diagnostic accuracy of periprosthetic joint infection following total hip arthroplasty

Klemt, Christian; Tirumala, Venkatsaiakhil; Smith, Evan J.; Xiong, Liang; Kwon, Young-Min

doi:10.1007/s00402-021-04309-w

Cited by 28 publications

(34 citation statements)

References 50 publications

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“…The remaining 11 articles were included in our meta-analysis. These included articles were retrospective investigations [ 22 , 23 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 ]. Table 1 summarizes the characteristics of the studies.…”

Section: Resultsmentioning

confidence: 99%

“…The site of PJI was reported in all studies involving patients affected by hip or knee prosthetic infections. Only three articles analyzed all four parameters [ 22 , 42 , 47 ] and all the included articles gave their cut-offs for discriminating PJI and aseptic failures for the analyzed ratios. The results of the QUADAS-2 assessment for each study are provided in Table 2 .…”

Section: Resultsmentioning

confidence: 99%

“…This parameter has been analyzed in four of the eleven included articles [ 22 , 42 , 46 , 47 ]. One thousand seven hundred ninety-one patients with a percentage of PJI of 43% (767/1791) were evaluated.…”

Section: Resultsmentioning

confidence: 99%

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Diagnostic Performance of Neutrophil to Lymphocyte Ratio, Monocyte to Lymphocyte Ratio, Platelet to Lymphocyte Ratio, and Platelet to Mean Platelet Volume Ratio in Periprosthetic Hip and Knee Infections: A Systematic Review and Meta-Analysis

et al. 2022

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The current literature on the diagnosis of periprosthetic joint infection provides controversial evidence on the diagnostic accuracy of MLR, NLR, PVR, and PLR. Therefore, this critical literature search and meta-analysis was aimed to summarize the diagnostic accuracy of these biomarkers for the diagnosis of hip and knee prosthetic infection. According to the PRISMA flowchart, we searched MEDLINE, Scopus, and Web of Science, for studies on these ratios for diagnosing PJI. Sensitivity, specificity, positive and negative likelihood ratio, diagnostic odds ratio, and AUC were analyzed. We included 11 articles in our meta-analysis, including 7537 patients who underwent total hip and knee arthroplasties; among these, 1974 (26%) patients reported a joint infection. The pooled sensitivity and specificity were 0.72 and 0.74, respectively, for NLR, 0.72 and 0.77 for PVR, and 0.77 and 0.75 for PLR. The sensitivity of MLR ranges from 0.54 to 0.81, while the specificity ranges from 0.78 to 0.81. Regarding the evaluation of AUCs, the best diagnostic performance was achieved by MLR (AUC = 0.77) followed by PLR (AUC = 0.75), NLR (AUC = 0.73), and PVR (AUC = 0.70). This meta-analysis demonstrates a fair diagnostic accuracy of these ratios, thus not being useful as a screening tool.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Diagnostic Performance of Neutrophil to Lymphocyte Ratio, Monocyte to Lymphocyte Ratio, Platelet to Lymphocyte Ratio, and Platelet to Mean Platelet Volume Ratio in Periprosthetic Hip and Knee Infections: A Systematic Review and Meta-Analysis

et al. 2022

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“…Previous studies had addressed the role of NLR, MLR, and PLR in infections and characterized the clinical prediction potential for bacterial infection and nonspecific infection [ 10 – 14 ]. In terms of research related to bone infections, these immune-related biomarkers, such as WBCs, CRP, ESR, NLR, MLR, and PLR, are increasingly being evaluated for their abilities of fast and early diagnosis of osteomyelitis and to predict complications [ 26 – 28 , 36 – 38 ]. In diabetic foot infection patients, PLR was significantly higher in osteomyelitis, and the cut-off value PLR > 187.3 had a sensitivity of 67.9% and a specificity of 59.1% in predicting osteomyelitis [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…Early postoperative NLR may help to recognize postoperative delirium in elderly patients undergoing surgery for lower limb fracture under nongeneral anaesthesia [ 25 ]. On the other hand, the predictive value of these markers for the prognosis of hand osteomyelitis, surgical site infection after spinal instrumentation surgery, and periprosthetic joint infection following total hip arthroplasty also needs to be further studied [ 26 – 28 ].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Value of the Blood Neutrophil-to-Lymphocyte Ratio and Monocyte-to-Lymphocyte Ratio in Tibia Fracture-Related Infection

et al. 2022

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Objective. The diagnostic value of neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) in predicting fracture-related infection (FRI) in tibia fracture patients remains to be explored. Methods. A retrospective controlled study was carried out with 170 tibia FRI patients and 162 control subjects. The following information was evaluated at admission: age, gender, clinical features, number of white blood cells (WBCs), neutrophils, lymphocytes, monocytes, red blood cells (RBCs), platelets, level of hemoglobin, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR), as well as NLR, MLR, and PLR. Results. The number of lymphocytes, RBCs, and platelets in the FRI group was higher than those in the control group, while the number of neutrophils and ESR level was lower ( P < 0.05 ). The level of NLR and MLR was significantly lower in patients with tibia FRI than in control subjects ( P < 0.05 ). Both indicators were positively correlated with WBCs, CRP level, and ESR level ( P < 0.001 ). The results of logistic regression analysis showed that five variables including NLR, MLR, platelets, fracture pattern (closed or open fracture), and site pattern (single or multiple site) were used to construct the FRI risk predictor. The ROC curve analysis result showed that FRI risk predictor yielded the highest AUC, with a sensitivity of 91.2% and a specificity of 90.1%, and made the distinction efficiently between tibia FRI patients and non-FRI patients. Conclusion. NLR and MLR were decreased in tibia FRI patients compared to non-FRI patients. Both indicators had a positive correlation with WBCs, CRP level, and ESR level. FRI risk predictor constructed based on five variables including NLR and MLR had a high diagnostic value for tibia FRI.

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Can machine learning models predict failure of revision total hip arthroplasty?

Klemt

Cohen-Levy

Robinson

et al. 2022

Arch Orthop Trauma Surg

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Complete blood platelet and lymphocyte ratios increase diagnostic accuracy of periprosthetic joint infection following total hip arthroplasty

Cited by 28 publications

References 50 publications

Diagnostic Performance of Neutrophil to Lymphocyte Ratio, Monocyte to Lymphocyte Ratio, Platelet to Lymphocyte Ratio, and Platelet to Mean Platelet Volume Ratio in Periprosthetic Hip and Knee Infections: A Systematic Review and Meta-Analysis

Diagnostic Performance of Neutrophil to Lymphocyte Ratio, Monocyte to Lymphocyte Ratio, Platelet to Lymphocyte Ratio, and Platelet to Mean Platelet Volume Ratio in Periprosthetic Hip and Knee Infections: A Systematic Review and Meta-Analysis

Diagnostic Value of the Blood Neutrophil-to-Lymphocyte Ratio and Monocyte-to-Lymphocyte Ratio in Tibia Fracture-Related Infection

Can machine learning models predict failure of revision total hip arthroplasty?

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