INFERIOR DIAGNOSTIC PERFORMANCE OF SERUM ALBUMIN-GLOBULIN-RATIO IN PERIPROSTHETIC JOINT INFECTION

• DOI: 10.1302/1358-992x.2023.17.068
• Publication Date: 2023-11-24T11:12:31Z
• Authors: Markus Luger; Reinhard Windhager; Irene Sigmund
• Keywords: Joint arthroplasty

Aim Serum parameters continue to be a focus of research in diagnosing periprosthetic joint infections (PJI). Several workgroups have recently proposed serum Albumin-Globulin-Ratio (AGR) as potential new biomarker. Due controversies the literature, its usability clinical practice remains uncertain. The aim this study was assess value AGR PJI preoperatively, especially comparison with well-established marker C-reactive Protein (CRP). Method From January 2015 June 2022, patients indicated revision hip (rTHA) and knee (rTKA) arthroplasty were included retrospective cohort prospectively collected data. A standardized diagnostic workup performed using 2021 European Bone Joint Infection Society (EBJIS) definition PJI, excluding CRP. Diagnostic accuracies CRP calculated by receiver operating characteristic curve (ROC) analysis. z-test used compare area under curves (AUC). Results total 275 rTHA rTKA included, 144 joints (52.4%) identified septic. Decreased elevated strongly associated optimal thresholds 1.253 9.4 mg/L, respectively. Sensitivities 62.5% (95%-confidence interval: 54.3–70.0) 73.6% (65.8–80.1), specificities 84.7% (77.5–89.9) 87.8% (80.9–92.4), showed significantly higher AUC than (0.807 (0.761–0.853) 0.736 (0.686–0.786); p<0.0001). Subgroup analysis acute versus chronic yielded for both (p<0.0001). Similar results observed when focusing on causative microorganism; better performance high-virulence compared low-virulence (p≤0.005). Furthermore, AUCs significant difference (p=0.043). Conclusions limited accuracy, cannot recommended an additional PJI. are generally unspecific can influenced comorbidities other foci infection. Additionally, may remain within normal levels low-grade Evaluating AGR, further possible pitfalls must considered, example increased latency until bottom values reached impact malnutrition.