Neutrophil to Lymphocyte Ratio May Be a Diagnostic Marker for Prosthetic Joint Infection

doi:10.4328/jcam.3918

Cited by 5 publications

(7 citation statements)

References 12 publications

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“…Our present study addressed that NLR had a fair diagnostic performance in predicting PJI with a sensitivity of 56.25%, speci city of 80.52%, and AUC of 0.658. In comparison to the study conducted by Golge [15], the sensitivity of NLR in our study was demonstrated to be relatively lower and the speci city higher when using an optimal cutoff of 2.52. Their study revealed that by using 2.45 as the optimal threshold, the sensitivity and speci city of NLR in detecting PJI was 90 and 72%, respectively [15].…”

Section: Discussioncontrasting

confidence: 84%

“…In comparison to the study conducted by Golge [15], the sensitivity of NLR in our study was demonstrated to be relatively lower and the speci city higher when using an optimal cutoff of 2.52. Their study revealed that by using 2.45 as the optimal threshold, the sensitivity and speci city of NLR in detecting PJI was 90 and 72%, respectively [15]. However, the study involved patients with either PJI or primary total knee arthroplasty, with the patients with primary arthroplasty being considered as the control group, which would have a great impact on the diagnostic performance of NLR because of the larger heterogeneity between the 2 groups.…”

Section: Discussioncontrasting

confidence: 84%

“…Recently, more studies have been evaluating new biomarkers in diagnosing PJI, such as platelet count, mean platelet volume, brinogen, and NLR [15,17,18]. Our present study addressed that NLR had a fair diagnostic performance in predicting PJI with a sensitivity of 56.25%, speci city of 80.52%, and AUC of 0.658.…”

Section: Discussionmentioning

confidence: 82%

“…Yombi et al investigated the distribution and uctuation of NLR compared with that of CRP in 587 patients who underwent total knee arthroplasty, and found that NLR had a faster normalization and was more stable than CRP, demonstrating that NLR might be utilized as a potential biomarker to monitor postoperative in ammation or early infection [16]. Another study conducted by Golge found that NLR was signi cantly increased in patients with PJI [15]. Similarly, in our study, the level of NLR was signi cantly higher in patients with PJI in comparison with patients with aseptic mechanic failure, even after adjustments for age, sex, joint, diabetes mellitus, and hypertension, indicating that NLR might play a pivotal role in the in ammatory condition of patients with PJI.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, Golge reported that NLR might be useful in the diagnosis of PJI, increasing the accuracy of the diagnosis when combined with CRP and ESR [15]. However, to the best of our knowledge, no solid evidence was found regarding the diagnostic value of NLR in predicting PJI.…”

Section: Introductionmentioning

confidence: 87%

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Neutrophil-Lymphocyte Ratio as A Complementary Biomarker of Periprosthetic Joint Infection: A Retrospective Review

Chen

et al. 2020

Preprint

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Background: Diagnosing a periprosthetic joint infection (PJI) is challenging. No single biomarker can accurately recognize PJI preoperatively in a timely manner. Therefore, the aim of the present study was to investigate the usefulness of the neutrophil-lymphocyte ratio (NLR) in aiding the diagnosis of PJI.Methods: We retrospectively evaluated the medical records of 109 patients who had undergone revision arthroplasty (77 with aseptic mechanic failure and 32 with PJI) from July 2011 to November 2018. Bivariate analysis followed by multivariate logistic regression was applied to compare NLR between two groups. The receiver operating characteristic (ROC) curve was used to assess the diagnostic performance of NLR alone and in combination with C-reactive protein (CRP) and the erythrocyte sedimentation ratio (ESR).Results: NLR was significantly higher in patients with PJI than in patients of the aseptic revision group (3.12 ± 2.45 vs. 2.10 ± 1.03, p < 0.05). ROC curve analysis revealed that NLR had a sensitivity of 56.25% and a specificity of 80.52% with an optimal threshold of 2.52. The diagnostic performance of NLR alone was inferior to that of CRP and ESR as demonstrated by the area under curve, sensitivity, and diagnostic odds ratio. When used in combination with CRP, the diagnostic performance was nearly equal to the combined performance of CRP and ESR or that of all three biomarkers (p > 0.05).Conclusions: NLR is associated with PJI and could be regarded as a complementary marker, which in combination with CRP could improve the diagnostic performance for PJI.

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Section: Discussioncontrasting

confidence: 84%

Section: Discussioncontrasting

confidence: 84%

Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 87%

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Neutrophil-Lymphocyte Ratio as A Complementary Biomarker of Periprosthetic Joint Infection: A Retrospective Review

Chen

et al. 2020

Preprint

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

Klemt,

Tirumala,

Smith

et al. 2022

Arch Orthop Trauma Surg

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Limited value of serum neutrophil-to-lymphocyte ratio in the diagnosis of chronic periprosthetic joint infection

Chen

et al. 2021

J Orthop Traumatol

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Background Diagnosing chronic periprosthetic joint infection (PJI) is challenging. No single biomarker can accurately recognize PJI preoperatively in a timely manner. Therefore, the aim of the present study was to investigate the usefulness of the serum neutrophil-to-lymphocyte ratio (NLR) in aiding the diagnosis of chronic PJI. Materials and methods We retrospectively evaluated the medical records of 158 patients who had undergone revision arthroplasty (104 with aseptic mechanic failure and 54 with chronic PJI) from July 2011 to July 2020. Univariate analysis followed by multivariate logistic regression was applied to compare NLR, C-reactive protein (CRP), and erythrocyte sedimentation ratio (ESR) between the two groups. The receiver operating characteristic (ROC) curve was used to assess the diagnostic performance of NLR alone and in combination with CRP and ESR. Results NLR, CRP, and ESR were significantly higher in patients with chronic PJI than in the aseptic revision group (p < 0.05). ROC curve analysis revealed that NLR had a sensitivity of 57.41% and a specificity of 77.88% with an optimal threshold of 2.56. The optimal threshold for CRP and ESR was 7.00 mg/L (sensitivity 62.50% and specificity 83.12%) and 43 mm/h (sensitivity 59.38% and specificity 80.52%), respectively. The combined diagnostic value of NLR with CRP and ESR was shown to have no additional diagnostic value in predicting chronic PJI. Conclusion Compared with traditional inflammatory biomarkers (ESR and CRP), the value of serum NLR alone or combined with CRP and ESR for diagnosing chronic PJI is limited. Level of evidence Level 3.

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Neutrophil to Lymphocyte Ratio May Be a Diagnostic Marker for Prosthetic Joint Infection

Abstract: Anahtar KelimelerNötrofil Lenfosit Oranı; Eklem Enfeksiyonu; Total Diz Protez Abstract Aim: Total knee arthroplasty

Cited by 5 publications

References 12 publications

Neutrophil-Lymphocyte Ratio as A Complementary Biomarker of Periprosthetic Joint Infection: A Retrospective Review

Neutrophil-Lymphocyte Ratio as A Complementary Biomarker of Periprosthetic Joint Infection: A Retrospective Review

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

Limited value of serum neutrophil-to-lymphocyte ratio in the diagnosis of chronic periprosthetic joint infection

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