CRP/Albumin Has a Promising Prospect as a New Biomarker for the Diagnosis of Periprosthetic Joint Infection

Weipeng Shi; Yingzhen Wang; Xuan Zhao; Tengbo Yu; Tao Li

doi:10.2147/IDR.S342652

CRP/Albumin Has a Promising Prospect as a New Biomarker for the Diagnosis of Periprosthetic Joint Infection

Infect Drug Resist. 2021 Dec 6:14:5145-5151. doi: 10.2147/IDR.S342652. eCollection 2021.

Authors

Weipeng Shi^{1

2}, Yingzhen Wang¹, Xuan Zhao³, Tengbo Yu¹, Tao Li¹

Affiliations

¹ Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, 266003, People's Republic of China.
² Medical Department of Qingdao University, Qingdao, Shandong, 266071, People's Republic of China.
³ Department of Rheumatism and Immunology, The Affiliated Hospital of Jining Medical University, Jining, 272007, People's Republic of China.

Abstract

Purpose: In the present study, we aimed to identify more effective biomarkers for the diagnosis of periprosthetic joint infection (PJI) by comparing the diagnostic ability of C-reactive protein (CRP)/albumin, systemic immune-inflammation index (SII), and existing biomarkers.

Methods: In this single-center retrospective analysis, 216 patients who underwent revision knee or hip arthroplasty from June 2013 to June 2021 and met the inclusion and exclusion criteria were analyzed, including 80 patients in the PJI group and 136 patients in the non-PJI group. The following information was collected for analysis, including CRP, fibrinogen, erythrocyte sedimentation rate (ESR), D-dimer, platelet count (PC), neutrophil count (N), lymphocyte count (Lym), and albumin count on the second day of admission. The receiver operating characteristic (ROC) curve was used to compare the diagnostic ability of various biomarkers, and further subgroup analysis was carried out in the PJI group.

Results: Compared with the non-PJI group, CRP, fibrinogen, D-dimer, ESR, CRP/albumin, and SII in the PJI group were significantly increased (P < 0.001), and their area under the curve (AUC) was 0.937, 0.878, 0.777, 0.914, 0.941, and 0.765, respectively. In the three subgroup analyses, there was no significant difference in appeal biomarker (P > 0.05) based on PJI culture results, infection time, and infection site.

Conclusion: CRP/albumin had a promising prospect as a new biomarker for the diagnosis of PJI, while it had insufficient predictive ability in the PJI subgroup analysis. However, SII had insufficient ability to diagnose PJI. Therefore, SII was not suitable to be used as a diagnostic biomarker.

Keywords: CRP/albumin; biomarker; periprosthetic joint infection; systemic immune-inflammation index.

Grants and funding

Partial financial support was received from the National Natural Science Foundation of China; Grant number: 81802151; Shandong Province Natural Science Foundation; Grant number: ZR2019MH012; China Postdoctoral Science Foundation; Grant number: 2018M642616; Qingdao Applied Foundational Research Youth Project; Grant number: 19-6-2-55-cg.