10 October 2023 : Laboratory Research
Diagnostic Value of Synovial Fluid Biomarkers for Periprosthetic Joint Infection: A Prospective, Double-blind Trial
Ying Xu123BCDE, Xueting Ma4BCD, Haoran Guo135CF, Hairong Tang1BF, Jiayu Liu1CD, Chengbin Wang163AG, Chi Wang73ADF*DOI: 10.12659/MSM.940842
Med Sci Monit 2023; 29:e940842
Table 5 Diagnostic efficiency of common infection biomarkers for periprosthetic joint infection.
| Variable | AUC value | Cut-off value | Sensitivity | Specificity | PPV | NPV |
|---|---|---|---|---|---|---|
| SF-WBC | 0.923 (95% CI: 0.884–0.982) | 2.360 | 82.1% | 92.9% | 91.4% | 84.8% |
| SF-PMN | 0.931 (95% CI: 0.870–0.992) | 0.695 | 83.8% | 97.0% | 96.9% | 84.6% |
| ESR | 0.856 (95% CI: 0.767–0.945) | 27.50 | 81.1% | 81.4% | 78.9% | 83.3% |
| WBC | 0.703 (95% CI: 0.590–0.817) | 6.125 | 76.3% | 60.5% | 63.0% | 74.3% |
| CRP | 0.855 (95% CI: 0.771–0.940) | 0.665 | 76.3% | 83.7% | 80.6% | 80.0% |
| IL-6 | 0.823 (95% CI: 0.731–0.915) | 5.160 | 92.1% | 65.1% | 70.0% | 90.3% |
| D-D | 0.587 (95% CI: 0.447–0.726) | 1.440 | 74.3% | 45.2% | 65.0% | 65.4% |
| Fib | 0.896 (95% CI: 0.828–0.964) | 4.43 | 78.4% | 87.2% | 85.3% | 81.0% |
| S100A8+SF-WBC+SF-PMN | 0.975 (95% CI: 0.943–1.000) | – | 94.6% | 93.9% | 94.6% | 93.9% |
| S100A9+SF-WBC+SF-PMN | 0.953 (95% CI: 0.898–1.000) | – | 89.2% | 97.0% | 97.1% | 88.9% |
| HNP1-3+SF-WBC+SF-PMN | 0.973 (95% CI: 0.938–1.000) | – | 89.2% | 100.0% | 100.0% | 89.2% |
| AUC – area under the ROC curve; 95% CI – 95% confidence interval; PPV – positive predictive value; NPV – negative predictive value; SF-WBC – synovial fluid white blood cell count; SF-PMN – percentage of polymorphonuclear neutrophil in the synovial fluid; ESR – erythrocyte sedimentation rate; WBC – whole blood white blood cell count; CRP – whole blood C-reactive protein; IL-6 – plasma interleukin-6; D-D – plasma D-dimer; Fib – plasma fibrinogen. | ||||||