Red cell distribution width, eosinophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio can predict the development of infection and the number of antibiotics used in elderly patients undergoing revision total knee arthroplasty

Yıl 2022, , 1292 - 1298, 25.09.2022

Leyla Kutlucan , Vahit Yıldız

https://doi.org/10.32322/jhsm.1116583

Öz

Introduction: We aimed to evaluate the relationship between complete blood parameters reported to be associated with inflammation and development of complications, length of hospital stays and the number of antibiotics used in elderly patients undergoing revision total knee arthroplasty (rTKA).
Material and Method: Our retrospective study was conducted in a single center and included 72 older patients who underwent rTKA operations. We recorded patients’ firs day preoperative, first day postoperative and 45th day postoperative whole blood parameters.
Results: It was found that the development of postoperative infection and the number of antibiotics used were higher in patients with low preoperative Hb values and high platelet-to-lymphocyte ratio (PLR) rates. In patients with high RDW value and high eosinophil-lymphocyte ratio (ELR) one day after surgery, both the development of infection (P=0.002, P=0.002) and the number of antibiotics used during follow-up were found to be significantly higher ​(P<0.001, P<0.001). When the laboratory parameters were evaluated 45 days after the operation, it was determined that the RDW (P=0.001, P=0.001) and ELR (P=0.039, P<0.001) elevations continued in the patients who developed infection and used multiple antibiotics. CRP and ESR values one day and 45 days after surgery were also found to be significantly associated with the development of infection and the use of multiple antibiotics.
Conclusion: RDW, ELR and PLR parameters may be as important as CRP and ESR in predicting the development of infection and the number of antibiotics used in elderly patients undergoing rTKA.

Anahtar Kelimeler

Eosinophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, red cell distribution width, revision total knee arthroplasty

Kaynakça

• Fehring TK, Christie MJ, Lavernia C, et al. Revision total knee arthroplasty: Planning, management, and controversies. Instr Course Lect 2008; 57: 341-63.
• Parratte S, Abdel MP, Lunebourg A, et al. Revision total knee arthroplasty: the end of the allograft era? Eur J Orthop Surg Traumatol 2015; 25: 621-2.
• Canadian Institute for Health Information. Available from: https://secure.cihi.ca/free_products/cjrr-annual-report-2018-en.pdf. Hip and Knee Replacements in Canada, 2016–2017: Canadian Joint Replacement Registry Annual Report. (Accessed: 11.05.2022)
• Sharkey PF, Lichstein PM, Shen C, Tokarski AT, Parvizi J. Why are total knee arthroplasties failing today–has anything changed after 10 years? J Arthroplasty 2014; 29: 1774–8.
• Menger M, Vollmar B. Surgical trauma: hyperinflammation versus immunosuppression? Langenbecks Arch Surg 2004; 389: 475-84.
• Wasko MK, Struminski M, Bobecka-Wesolowska K, Kowalczewski J. Neutrophil-to-lymphocyte ratio shows faster changing kinetics than C-reactive protein after total hip and knee arthroplasty. J Orthop Translat 2017; 10: 36-41.
• Barker T, Rogers VE, Henriksen VT, et al. Is there a link between the neutrophil-to-lymphocyte ratio and venous thromboembolic events after knee arthroplasty? A pilot study. J Orthop Traumatol 2016; 17: 163-8.
• Paziuk T, Rondon AJ, Goswami K, Tan TL, Parvizi J. A novel adjunct indicator of periprosthetic joint infection: platelet count and mean platelet volume. J Arthroplasty 2020; 35: 836-9.
• Yombi JC, Schwab PE, Thienpont E. Neutrophil-to-lymphocyte ratio (NLR) distribution shows a better kinetic pattern than C-reactive protein distribution for the follow-up of early inflammation after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2016; 24: 3287-92.
• Chawla A, Paraoan V, Rabiu R, et al. Determining the stress biomarker profile in patients undergoing total knee replacement and the relationship with outcome at 12 months. Knee 2019; 26: 1379-85.
• Zehir S, Sipahioğlu S, Ozdemir G, Sahin E, Yar U, Akgül T. Red cell distribution width and mortality in patients with hip fracture treated with partial prosthesis. Acta Orthop Traumatol Turc 2014; 48: 141-6.
• Lechiancole A, Sponga S, Vendramin I, et al. Red blood distribution width and heart transplantation: any predictive role on patient outcome? J Cardiovasc Med 2019; 20: 145-51.
• Hirahara N, Tajima Y, Fujii Y, et al. Comprehensive analysis of red blood cell distribution width as a preoperative prognostic predictor in gastric cancer. Anticancer Res 2019; 39: 3121-30.
• Aali-rezai A, Alijanipour P, Shohat N, Vahedi H, Foltz C, Parvizi J. Red cell distribution width: an unacknowledged predictor of mortality and adverse outcomes following revision arthroplasty. J Arthroplasty 2018; 33: 3514-9.
• Martin JR, Beahrs TR, Stuhlman CR, Trousdale RT. Complex primary total knee arthroplasty: long-term outcomes. J Bone Joint Surg Am 2016; 98: 1459-70.
• Chalmers BP, Berbari EF, Osmon DR, Hanssen AD, Berry DJ, Abdel MP. Elevated infection and complication rates in patients undergoing a primary tha with a history of a pji in a prior hip or knee arthroplasty: a matched cohort study. J Arthroplasty 2020; 35: 1928-32.
• Hansen EN, Ong KL, Lau E, Kurtz SM, Lonner JH. Unicondylar knee arthroplasty has fewer complications but higher revision rates than total knee arthroplasty in a study of large united states databases. J Arthroplasty 2019; 34: 1617-25.
• Naranje S, Lendway L, Mehle S, Gioe TJ. Does operative time affect infection rate in primary total knee arthroplasty? Clin Orthop Relat Res 2015; 473: 64-9.
• Turki ASA, Dakhil YA, Turki AA, Ferwana MS. Total knee arthroplasty: effect of obesity and other patients’ characteristics on operative duration and outcome. World J Orthop 2015; 6: 284-9.
• Yao C, Zhang Z, Yao Y, Xu X, Jiang Q, Shi D. Predictive value of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio for acute deep vein thrombosis after total joint arthroplasty: a retrospective study. J Orthop Surg Res 2018; 13: 40.
• Kara A, Guven M, Yilmaz MS, Demir D, Elden H. Are neutrophil, platelet and eosinophil-to-lymphocyte ratio and red blood cell distribution width can be used for nasal polyposis? Eur Arch Oto Rhino Laryngol 2018; 275: 409-13.
• Catal O, Ozer B, Sit M. Prediction of lymph node metastasis in colon cancer via platelet to lymphocyte ratio and platelet count. J Coll Physicians Surg Pak 2020; 30: 250-3.
• Aktepe OH, Güner G, Güven DC, et al. The platelet to lymphocyte ratio predicts overall survival better than the neutrophil to lymphocyte ratio in metastatic renal cell carcinoma. Turk J Med Sci 2021; 51: 757-65.
• Kökoğlu K, Şahin MI. Use of neutrophil, eosinophil, basophil, and platelet to lymphocyte ratio to predict patient satisfaction after septoplasty plus inferior turbinate reduction. J Craniofac Surg 2019; 30: 1022-6.
• Seringec Akkececi N, Yildirim Cetin G, Gogebakan H, Acipayam C. The c-reactive protein/albumin ratio and complete blood count parameters as indicators of disease activity in patients with takayasu arteritis. Med Sci Monit 2019; 25: 1401-9.