Excellent AUC for joint fluid cytology in the detection/exclusion of hip and knee prosthetic joint infection

Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
Jiří GalloJana Zapletalova

Abstract

The aim of this study was to evaluate the characteristics of synovial fluid (SF) white cell count (SWCC) and neutrophil/lymphocyte percentage in the diagnosis of prosthetic joint infection (PJI) for particular threshold values. This was a prospective study of 391 patients in whom SF specimens were collected before total joint replacement revisions. SF was aspirated before joint capsule incision. The PJI diagnosis was based only on non-SF data. Receiver operating characteristic plots were constructed for the SWCC and differential counts of leukocytes in aspirated fluid. Logistic binomic regression was used to distinguish infected and non-infected cases in the combined data. PJI was diagnosed in 78 patients, and aseptic revision in 313 patients. The areas (AUC) under the curve for the SWCC, the neutrophil and lymphocyte percentages were 0.974, 0.962, and 0.951, respectively. The optimal cut-off for PJI was 3,450 cells/μL, 74.6% neutrophils, and 14.6% lymphocytes. Positive likelihood ratios for the SWCC, neutrophil and lymphocyte percentages were 19.0, 10.4, and 9.5, respectively. Negative likelihood ratios for the SWCC, neutrophil and lymphocyte percentages were 0.06, 0.076, and 0.092, respectively. Based on AUC, the present stud...Continue Reading

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Citations

Dec 8, 2019·Expert Review of Medical Devices·Stuart B GoodmanMichiaki Takagi
Feb 11, 2021·Journal of Clinical Medicine·Michael FuchsF Andrea Sass
Jun 3, 2020·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Katyayini SharmaRobin Patel

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