Serum globulin and albumin to globulin ratio as potential diagnostic biomarkers for periprosthetic joint infection: a re
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(2020) 15:459
RESEARCH ARTICLE
Open Access
Serum globulin and albumin to globulin ratio as potential diagnostic biomarkers for periprosthetic joint infection: a retrospective review Yongyu Ye, Weishen Chen, Minghui Gu, Guoyan Xian, Baiqi Pan, Linli Zheng, Ziji Zhang* and Puyi Sheng*
Abstract Background: Periprosthetic joint infection (PJI) has been increasingly documented; however, its preoperative accurate diagnosis remains challenging. Furthermore, there is a dire need to identify appropriate and effective biomarkers. We aimed to evaluate the relationship between globulin, albumin to globulin (A/G) ratio, and development of PJI in patients undergoing revision total joint arthroplasty (TJA). Methods: A retrospective study was conducted on patients who had undergone revision TJA between 2011 and 2018 (89 with aseptic mechanic failure and 38 with PJI). The serum proteins were explored using univariate analysis followed by multivariate logistic regression. The diagnostic performance of these proteins was assessed by the receiver operating characteristic (ROC) curve. Results: Higher globulin levels (odds ratio [OR], 1.239; P < 0.001) and lower A/G ratio (OR, 0.007; P < 0.001) were strongly associated with the risk of PJI. ROC curve analysis demonstrated reasonable diagnostic performance for globulin (area under the curve [AUC], 0.77; sensitivity, 78.95%; and specificity, 69.66%) and A/G ratio (AUC, 0.779; sensitivity, 65.79%; and specificity, 78.65%). Conclusions: Both globulin and A/G ratio were associated with PJI and may serve as potential adjuvant biomarkers in the diagnosis of PJI. Keywords: Periprosthetic joint infection, Globulin, Albumin to globulin ratio, Diagnosis
Background Total joint arthroplasty (TJA) is a successful surgery to relieve pain and improve the quality of life. However, subsequent complications, especially the periprosthetic joint infection (PJI), have been increasingly recorded over decades [1–3]. The rate of debilitating PJI following TJA is approximately 1–2.5%, imposing a huge burden on the individuals and health care system [3, 4]. * Correspondence: [email protected]; [email protected]; [email protected] Department of Orthopedic Surgery, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan 2nd Road, Guangzhou 510080, China
Furthermore, the variability in the clinical presentation and the bacterial profile as well as the lack of reliable biomarkers make the timely and accurate diagnosis of PJI even more challenging. Though several biomarkers have been developed as per the Musculoskeletal Infection Society (MSIS) guidelines recently [2, 5, 6], some cases still remain unidentified or misdiagnosed, particularly in those with chronic and low virulence infections [6, 7]. Consequently, additional efforts are required to optimize PJI diagnosis by determining the appropriate and effective biomarkers.
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adapta
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