Periprostetik eklem enfeksiyonlarında preoperatif kan parametrelerinin tanısal değeri

Year 2023, , 133 - 138, 27.03.2023

İzzet Korkmaz

https://doi.org/10.47582/jompac.1257586

Abstract

Amaç: Periprostetik eklem enfeksiyonunun (PEE) tanısı kolay değildir ve tek bulgu yerine kombine bulguların sunulması ile konur. Bu çalışmanın amacı, PJI tanısında kan parametrelerinin rolünü araştırmaktır.
Gereç ve yöntem: Bu çalışmaya 2008-2018 yılları arasında aynı cerrah tarafından gerçekleştirilen total diz protezi ve total kalça protezi revizyonları dahil edildi. Hastaların ameliyat öncesi kan parametreleri kaydedildi. Hastalarla benzer demografik özelliklere sahip 69 primer artroplasti hastası da kontrol grubu olarak alındı.
Bulgular: Bu çalışmaya %79.0'u kadın (n=169) olmak üzere 214 artroplasti hastası dahil edildi. Hastalar 3 gruba ayrıldı; %32,2'si primer artroplasti, %36,9'u aseptik revizyon artroplastisi ve %30,8'i septik revizyon artroplastisi idi. Üç grup arasında demografik özellikler açısından fark yoktu. İkili karşılaştırmalarda preoperatif eritrosit sedimantasyon hızı (ESR), C-reaktif protein (CRP), lenfosit ve trombosit-lenfosit hızı (PLR) parametrelerinin septik grupta her iki aseptik gruba göre anlamlı olarak farklı olduğu bulundu. ve birincil artroplasti grubu. PJI'de aseptik hastalara göre ESR, CRP, lenfosit ve PLR'nin tanısal performanslarını değerlendirmek için çalışma karakteristik eğrilerini çizerek ileri analizler yapıldı.
Sonuç: Lenfosit, PLR, ESR ve CRP, PJI'yi öngörmede tanısal değere sahip olabilir. Bu nedenle, bu parametreler PJI için revizyon artroplastisine karar vermede yardımcı olabilir.

Keywords

Periprostetik eklem enfeksiyonu, diz artroplastisi, kalça artroplastisi, kan parametreleri, revizyon artroplastisi

Diagnostic value of preoperative blood parameters in periprosthetic joint infections

Abstract

Aim: Diagnosis of periprosthetic joint infection (PJI) is not easy and it is made by presenting of combined findings rather than a single finding. The aim of this study is to investigate the role of blood parameters in diagnosing PJI.
Material and Method: Revisions of total knee replacement and total hip replacement operated by the same surgeon between 2008 and 2018 were included in this study. Preoperative blood parameters of the patients were recorded. 69 primary arthroplasty patients with similar demographic characteristics to the patients were also included as the control group.
Results: 214 arthroplasty patients, 79.0% of whom were female (n=169), were included in this study. The patients were divided into 3 groups; 32.2% were primary arthroplasty, 36.9% were aseptic revision arthroplasty, and 30.8% were septic revision arthroplasty. There was no difference between the three groups in terms of demographic characteristics. In pairwise comparisons, preoperative erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), lymphocyte, and platelet-to-lymphocyte rate (PLR) parameters were found to be significantly different in the septic group when compared to both the aseptic group and the primary arthroplasty group. Further analyzes were performed to evaluate the diagnostic performances of ESR, CRP, lymphocyte, and PLR in PJI relative to aseptic patients by plotting to receive operating characteristic curves.
Conclusion: Lymphocyte, PLR, ESR, and CRP may have diagnostic value in predicting PJI. Therefore, these parameters may be helpful in deciding on revision arthroplasty for PJI.

Keywords

Periprosthetic joint infection, knee arthroplasty, hip arthroplasty, blood parameters, revision arthroplasty

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