Predicting the Exception—CRP and Primary Hip Arthroplasty
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 (C...
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| Format: | Article |
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MDPI AG
2021-10-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/21/4985 |
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| author | Marc-Pascal Meier Ina Juliana Bauer Arvind K. Maheshwari Martin Husen Katharina Jäckle Jan Hubert Thelonius Hawellek Wolfgang Lehmann Dominik Saul |
| author_facet | Marc-Pascal Meier Ina Juliana Bauer Arvind K. Maheshwari Martin Husen Katharina Jäckle Jan Hubert Thelonius Hawellek Wolfgang Lehmann Dominik Saul |
| author_sort | Marc-Pascal Meier |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-10T05:59:44Z |
| format | Article |
| id | doaj.art-685eecf9690443639e2c24396f27a3b5 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T05:59:44Z |
| publishDate | 2021-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-685eecf9690443639e2c24396f27a3b52023-11-22T21:05:36ZengMDPI AGJournal of Clinical Medicine2077-03832021-10-011021498510.3390/jcm10214985Predicting the Exception—CRP and Primary Hip ArthroplastyMarc-Pascal Meier0Ina Juliana Bauer1Arvind K. Maheshwari2Martin Husen3Katharina Jäckle4Jan Hubert5Thelonius Hawellek6Wolfgang Lehmann7Dominik Saul8Department of Trauma, Orthopedics and Reconstructive Surgery, Georg-August-University of Goettingen, 37075 Göttingen, GermanyDepartment of Trauma, Orthopedics and Reconstructive Surgery, Georg-August-University of Goettingen, 37075 Göttingen, GermanyKogod Center on Aging and Division of Endocrinology, Mayo Clinic, Rochester, MN 55905, USADepartment of Orthopedic Surgery, Rochester, MN 55905, USADepartment of Trauma, Orthopedics and Reconstructive Surgery, Georg-August-University of Goettingen, 37075 Göttingen, GermanyDivision of Orthopaedics, Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, 20521 Hamburg, GermanyDepartment of Trauma, Orthopedics and Reconstructive Surgery, Georg-August-University of Goettingen, 37075 Göttingen, GermanyDepartment of Trauma, Orthopedics and Reconstructive Surgery, Georg-August-University of Goettingen, 37075 Göttingen, GermanyDepartment of Trauma, Orthopedics and Reconstructive Surgery, Georg-August-University of Goettingen, 37075 Göttingen, GermanyBackground: 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.https://www.mdpi.com/2077-0383/10/21/4985C-reactive proteinCRPprimary hip arthroplastyorthopedic surgeryrevision surgeryperiprosthetic joint infection |
| spellingShingle | Marc-Pascal Meier Ina Juliana Bauer Arvind K. Maheshwari Martin Husen Katharina Jäckle Jan Hubert Thelonius Hawellek Wolfgang Lehmann Dominik Saul Predicting the Exception—CRP and Primary Hip Arthroplasty Journal of Clinical Medicine C-reactive protein CRP primary hip arthroplasty orthopedic surgery revision surgery periprosthetic joint infection |
| title | Predicting the Exception—CRP and Primary Hip Arthroplasty |
| title_full | Predicting the Exception—CRP and Primary Hip Arthroplasty |
| title_fullStr | Predicting the Exception—CRP and Primary Hip Arthroplasty |
| title_full_unstemmed | Predicting the Exception—CRP and Primary Hip Arthroplasty |
| title_short | Predicting the Exception—CRP and Primary Hip Arthroplasty |
| title_sort | predicting the exception crp and primary hip arthroplasty |
| topic | C-reactive protein CRP primary hip arthroplasty orthopedic surgery revision surgery periprosthetic joint infection |
| url | https://www.mdpi.com/2077-0383/10/21/4985 |
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