The mildly decreased preoperative bilirubin level is a risk factor for periprosthetic joint infection after total hip and knee arthroplasty

Abstract Background Many serologic markers are routinely tested prior to joint arthroplasty, but only few are commonly used to guide surgeons in determining patients most at risk of periprosthetic joint infection (PJI). The objective of this study was to investigate the association between preoperat...

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Autores principales:	Jun Fu, Xiyue Chen, Ming Ni, Xiang Li, Libo Hao, Guoqiang Zhang, Jiying Chen
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Arthroplasty Periprosthetic joint infection Bilirubin Risk factor Orthopedic surgery RD701-811
Acceso en línea:	https://doaj.org/article/aa5acc7a1acf4abd97ea45c7549034eb
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spelling	oai:doaj.org-article:aa5acc7a1acf4abd97ea45c7549034eb2021-12-05T12:26:25ZThe mildly decreased preoperative bilirubin level is a risk factor for periprosthetic joint infection after total hip and knee arthroplasty10.1186/s42836-021-00096-22524-7948https://doaj.org/article/aa5acc7a1acf4abd97ea45c7549034eb2021-12-01T00:00:00Zhttps://doi.org/10.1186/s42836-021-00096-2https://doaj.org/toc/2524-7948Abstract Background Many serologic markers are routinely tested prior to joint arthroplasty, but only few are commonly used to guide surgeons in determining patients most at risk of periprosthetic joint infection (PJI). The objective of this study was to investigate the association between preoperative bilirubin level and PJI after primary hip and knee arthroplasty. Methods A retrospective analysis was performed on patients undergoing revision hip and knee arthroplasty at our hospital from January 2016 to December 2019. Laboratory biomarkers were collected before the primary arthroplasty, as well as general patient information. The association between the above serologic markers and postoperative PJI was analyzed. Results A total of 72 patients (30 hips/42 knees) were analyzed, including 39 patients with PJI and 33 patients without PJI. Except for total bilirubin (TB) and direct bilirubin (DB), there was no significant difference between the remaining laboratory biomarkers. The preoperative TB and DB in the PJI group were 10.84 ± 0.61 μmol/L and 3.07 ± 0.19 μmol/L, respectively, which were lower than those in the non-PJI group (14.68 ± 0.75 μmol/L and 4.70 ± 0.39 μmol/L, P < 0.001). The area under the curve (AUC) of preoperative TB to predict PJI was 0.755 (P < 0.001, cutoff = 11.55 μmol/L, sensitivity = 66.67%, specificity = 75.76%). Meanwhile, the AUC of preoperative DB was 0.760 (P < 0.001, cutoff = 4.00 μmol/L, sensitivity = 84.62%, specificity = 54.45%). Conclusions The serum levels of TB and DB before the primary arthroplasty were lower in PJI patients than in non-PJI patients, and the preoperative values lower than 11.55 μmol/L and 4.00 μmol/L could be considered as a risk factor for postoperative PJI.Jun FuXiyue ChenMing NiXiang LiLibo HaoGuoqiang ZhangJiying ChenBMCarticleArthroplastyPeriprosthetic joint infectionBilirubinRisk factorOrthopedic surgeryRD701-811ENArthroplasty, Vol 3, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Arthroplasty Periprosthetic joint infection Bilirubin Risk factor Orthopedic surgery RD701-811
spellingShingle	Arthroplasty Periprosthetic joint infection Bilirubin Risk factor Orthopedic surgery RD701-811 Jun Fu Xiyue Chen Ming Ni Xiang Li Libo Hao Guoqiang Zhang Jiying Chen The mildly decreased preoperative bilirubin level is a risk factor for periprosthetic joint infection after total hip and knee arthroplasty
description	Abstract Background Many serologic markers are routinely tested prior to joint arthroplasty, but only few are commonly used to guide surgeons in determining patients most at risk of periprosthetic joint infection (PJI). The objective of this study was to investigate the association between preoperative bilirubin level and PJI after primary hip and knee arthroplasty. Methods A retrospective analysis was performed on patients undergoing revision hip and knee arthroplasty at our hospital from January 2016 to December 2019. Laboratory biomarkers were collected before the primary arthroplasty, as well as general patient information. The association between the above serologic markers and postoperative PJI was analyzed. Results A total of 72 patients (30 hips/42 knees) were analyzed, including 39 patients with PJI and 33 patients without PJI. Except for total bilirubin (TB) and direct bilirubin (DB), there was no significant difference between the remaining laboratory biomarkers. The preoperative TB and DB in the PJI group were 10.84 ± 0.61 μmol/L and 3.07 ± 0.19 μmol/L, respectively, which were lower than those in the non-PJI group (14.68 ± 0.75 μmol/L and 4.70 ± 0.39 μmol/L, P < 0.001). The area under the curve (AUC) of preoperative TB to predict PJI was 0.755 (P < 0.001, cutoff = 11.55 μmol/L, sensitivity = 66.67%, specificity = 75.76%). Meanwhile, the AUC of preoperative DB was 0.760 (P < 0.001, cutoff = 4.00 μmol/L, sensitivity = 84.62%, specificity = 54.45%). Conclusions The serum levels of TB and DB before the primary arthroplasty were lower in PJI patients than in non-PJI patients, and the preoperative values lower than 11.55 μmol/L and 4.00 μmol/L could be considered as a risk factor for postoperative PJI.
format	article
author	Jun Fu Xiyue Chen Ming Ni Xiang Li Libo Hao Guoqiang Zhang Jiying Chen
author_facet	Jun Fu Xiyue Chen Ming Ni Xiang Li Libo Hao Guoqiang Zhang Jiying Chen
author_sort	Jun Fu
title	The mildly decreased preoperative bilirubin level is a risk factor for periprosthetic joint infection after total hip and knee arthroplasty
title_short	The mildly decreased preoperative bilirubin level is a risk factor for periprosthetic joint infection after total hip and knee arthroplasty
title_full	The mildly decreased preoperative bilirubin level is a risk factor for periprosthetic joint infection after total hip and knee arthroplasty
title_fullStr	The mildly decreased preoperative bilirubin level is a risk factor for periprosthetic joint infection after total hip and knee arthroplasty
title_full_unstemmed	The mildly decreased preoperative bilirubin level is a risk factor for periprosthetic joint infection after total hip and knee arthroplasty
title_sort	mildly decreased preoperative bilirubin level is a risk factor for periprosthetic joint infection after total hip and knee arthroplasty
publisher	BMC
publishDate	2021
url	https://doaj.org/article/aa5acc7a1acf4abd97ea45c7549034eb
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The mildly decreased preoperative bilirubin level is a risk factor for periprosthetic joint infection after total hip and knee arthroplasty

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