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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Autores principales:	Marc-Pascal Meier, Ina Juliana Bauer, Arvind K. Maheshwari, Martin Husen, Katharina Jäckle, Jan Hubert, Thelonius Hawellek, Wolfgang Lehmann, Dominik Saul
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	C-reactive protein CRP primary hip arthroplasty orthopedic surgery revision surgery periprosthetic joint infection Medicine R
Acceso en línea:	https://doaj.org/article/685eecf9690443639e2c24396f27a3b5
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spelling	oai:doaj.org-article:685eecf9690443639e2c24396f27a3b52021-11-11T17:36:55ZPredicting the Exception—CRP and Primary Hip Arthroplasty10.3390/jcm102149852077-0383https://doaj.org/article/685eecf9690443639e2c24396f27a3b52021-10-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/21/4985https://doaj.org/toc/2077-0383Background: 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.Marc-Pascal MeierIna Juliana BauerArvind K. MaheshwariMartin HusenKatharina JäckleJan HubertThelonius HawellekWolfgang LehmannDominik SaulMDPI AGarticleC-reactive proteinCRPprimary hip arthroplastyorthopedic surgeryrevision surgeryperiprosthetic joint infectionMedicineRENJournal of Clinical Medicine, Vol 10, Iss 4985, p 4985 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	C-reactive protein CRP primary hip arthroplasty orthopedic surgery revision surgery periprosthetic joint infection Medicine R
spellingShingle	C-reactive protein CRP primary hip arthroplasty orthopedic surgery revision surgery periprosthetic joint infection Medicine R 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
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.
format	article
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
title	Predicting the Exception—CRP and Primary Hip Arthroplasty
title_short	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_sort	predicting the exception—crp and primary hip arthroplasty
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/685eecf9690443639e2c24396f27a3b5
work_keys_str_mv	AT marcpascalmeier predictingtheexceptioncrpandprimaryhiparthroplasty AT inajulianabauer predictingtheexceptioncrpandprimaryhiparthroplasty AT arvindkmaheshwari predictingtheexceptioncrpandprimaryhiparthroplasty AT martinhusen predictingtheexceptioncrpandprimaryhiparthroplasty AT katharinajackle predictingtheexceptioncrpandprimaryhiparthroplasty AT janhubert predictingtheexceptioncrpandprimaryhiparthroplasty AT theloniushawellek predictingtheexceptioncrpandprimaryhiparthroplasty AT wolfganglehmann predictingtheexceptioncrpandprimaryhiparthroplasty AT dominiksaul predictingtheexceptioncrpandprimaryhiparthroplasty
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Predicting the Exception—CRP and Primary Hip Arthroplasty

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