| Title |
Accuracy of different diagnostic tests for early, delayed and late prosthetic joint infection
|
|---|---|
| Published in |
BMC Infectious Diseases, August 2017
|
| DOI | 10.1186/s12879-017-2693-1 |
| Pubmed ID | |
| Authors |
M. Fernández-Sampedro, C. Fariñas-Alvarez, C. Garces-Zarzalejo, M. A. Alonso-Aguirre, C. Salas-Venero, L. Martínez-Martínez, M. C. Fariñas |
| Abstract |
A combination of laboratory, histopathological and microbiological tests for diagnosis of prosthetic joint infection (PJI) have been strongly recommended. This study aims to characterize the accuracy of individual or group tests, such as culture of sonicate fluid, synovial fluid and peri-implant tissue, C-reactive protein (CRP) and histopathology for detection of early, delayed and late PJI. A prospective study of patients undergoing hip or knee arthroplasty from February 2009 to February 2014 was performed in a Spanish tertiary health care hospital. The diagnostic accuracy of the different methods was evaluated constructing receiver-operating-characteristic (ROC) curve areas. One hundred thirty consecutive patients were included: 18 (13.8%) early PJI, 35 (27%) delayed PJI and 77 (59.2%) late PJI. For individual parameters, the area under the ROC curve for peri-implant tissue culture was larger for early (0.917) than for delayed (0.829) and late PJI (0.778), p = 0.033. There was a significantly larger difference for ROC area in the synovial fluid culture for delayed (0.803) than for early (0.781) and late infections (0.679), p = 0.039. The comparison of the areas under the ROC curves for the two microbiological tests showed that sonicate fluid was significantly different from peri-implant tissue in delayed (0.951 vs 0.829, p = 0.005) and late PJI (0.901 vs 0.778, p = 0.000). The conjunction of preoperative parameters, synovial fluid culture and CRP, improved the accuracy for late PJI (p = 0.01). The conjunction of histopathology and sonicate fluid culture increased the area under ROC curve of sonication in early (0.917 vs 1.000); p = 0.06 and late cases (0.901 vs 0.999); p < 0.001. For early PJI, sonicate fluid and peri-implant tissue cultures achieve the same best sensitivity. For delayed and late PJI, sonicate fluid culture is the most sensitive individual diagnostic method. By combining histopathology and peri-implant tissue, all early, 97% of delayed and 94.8% of late cases are diagnosed. The conjunction of histopathology and sonicate fluid culture yields a sensitivity of 100% for all types of infection. |
X Demographics
The data shown below were collected from the profiles of 11 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 5 | 45% |
| Unknown | 6 | 55% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 9 | 82% |
| Practitioners (doctors, other healthcare professionals) | 1 | 9% |
| Science communicators (journalists, bloggers, editors) | 1 | 9% |
Mendeley readers
The data shown below were compiled from readership statistics for 77 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 77 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 10 | 13% |
| Student > Doctoral Student | 10 | 13% |
| Other | 8 | 10% |
| Researcher | 8 | 10% |
| Student > Ph. D. Student | 4 | 5% |
| Other | 10 | 13% |
| Unknown | 27 | 35% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 33 | 43% |
| Immunology and Microbiology | 4 | 5% |
| Engineering | 3 | 4% |
| Nursing and Health Professions | 2 | 3% |
| Materials Science | 2 | 3% |
| Other | 2 | 3% |
| Unknown | 31 | 40% |
Attention Score in Context
This research output has an Altmetric Attention Score of 9. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 26 October 2017.
All research outputs
#4,238,119
of 25,732,188 outputs
Outputs from BMC Infectious Diseases
#1,435
of 8,694 outputs
Outputs of similar age
#67,894
of 325,484 outputs
Outputs of similar age from BMC Infectious Diseases
#21
of 159 outputs
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