Is combining serum interleukin-6 and C-reactive protein a reliable diagnostic tool in periprosthetic joint infections?
Abstract Background Because there is no single gold standard method for the diagnosis of periprosthetic joint infection (PJI), the combination of valuable methods to evaluate infection appears to achieve a better diagnostic result. The objective of the present study was to evaluate the diagnostic va...
Main Authors: | , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
BMC
2020-10-01
|
Series: | Journal of Orthopaedic Surgery and Research |
Subjects: | |
Online Access: | http://link.springer.com/article/10.1186/s13018-020-01864-7 |
id |
doaj-d5a12d7f04094128bbb2d9b68dfb1215 |
---|---|
record_format |
Article |
spelling |
doaj-d5a12d7f04094128bbb2d9b68dfb12152020-11-25T02:49:52ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2020-10-0115111410.1186/s13018-020-01864-7Is combining serum interleukin-6 and C-reactive protein a reliable diagnostic tool in periprosthetic joint infections?Cheng Li0Christina Ojeda Thies1Chi Xu2Andrej Trampuz3Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Center for Musculoskeletal Surgery (CMSC)Hospital Universitario 12 de OctubreDepartment of Orthopaedic Surgery, General Hospital of People’s Liberation ArmyCharité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Center for Musculoskeletal Surgery (CMSC)Abstract Background Because there is no single gold standard method for the diagnosis of periprosthetic joint infection (PJI), the combination of valuable methods to evaluate infection appears to achieve a better diagnostic result. The objective of the present study was to evaluate the diagnostic value of serum interleukin (IL)-6 and C-reactive protein (CRP) for the diagnosis of PJI. Methods PubMed, Embase, and the Web of Science databases were searched for articles describing PJI diagnosis using serum IL-6 and CRP published between January 1990 and December 2019. Results Eight studies were included in the meta-analysis. The pooled sensitivity was 0.84 (95% confidence interval [CI], 0.80−0.88) for the combined method (serum IL-6 and CRP) in series and parallel approaches, 0.87 (95% CI, 0.82−0.90) for IL-6, and 0.84 (95% CI, 0.79−0.88) for CRP. The pooled specificity was 0.85 (95% CI, 0.82−0.88) for the combined method, 0.83 (95% CI, 0.79−0.87) for IL-6, and 0.83 (95% CI, 0.79−0.87) for CRP. The combined method had the highest value for the area under the curve (0.9453), followed by IL-6 (0.9237) and CRP (0.9074). Subgroup analyses showed that the sensitivity of the combined method in parallel tests was higher than that in IL-6 or CRP (94% vs. 89% and 84%, respectively). Serial testing of the combined method showed increased specificity compared to a single indicator (96% vs. 83% and 80%). Conclusion The combination of serum IL-6 and CRP was a reliable tool for the diagnosis of periprosthetic hip and knee infection, demonstrating a better diagnostic accuracy than single marker analysis.http://link.springer.com/article/10.1186/s13018-020-01864-7Periprosthetic joint infectionArthroplastySerumInterleukin-6C-reactive proteinDiagnosis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Cheng Li Christina Ojeda Thies Chi Xu Andrej Trampuz |
spellingShingle |
Cheng Li Christina Ojeda Thies Chi Xu Andrej Trampuz Is combining serum interleukin-6 and C-reactive protein a reliable diagnostic tool in periprosthetic joint infections? Journal of Orthopaedic Surgery and Research Periprosthetic joint infection Arthroplasty Serum Interleukin-6 C-reactive protein Diagnosis |
author_facet |
Cheng Li Christina Ojeda Thies Chi Xu Andrej Trampuz |
author_sort |
Cheng Li |
title |
Is combining serum interleukin-6 and C-reactive protein a reliable diagnostic tool in periprosthetic joint infections? |
title_short |
Is combining serum interleukin-6 and C-reactive protein a reliable diagnostic tool in periprosthetic joint infections? |
title_full |
Is combining serum interleukin-6 and C-reactive protein a reliable diagnostic tool in periprosthetic joint infections? |
title_fullStr |
Is combining serum interleukin-6 and C-reactive protein a reliable diagnostic tool in periprosthetic joint infections? |
title_full_unstemmed |
Is combining serum interleukin-6 and C-reactive protein a reliable diagnostic tool in periprosthetic joint infections? |
title_sort |
is combining serum interleukin-6 and c-reactive protein a reliable diagnostic tool in periprosthetic joint infections? |
publisher |
BMC |
series |
Journal of Orthopaedic Surgery and Research |
issn |
1749-799X |
publishDate |
2020-10-01 |
description |
Abstract Background Because there is no single gold standard method for the diagnosis of periprosthetic joint infection (PJI), the combination of valuable methods to evaluate infection appears to achieve a better diagnostic result. The objective of the present study was to evaluate the diagnostic value of serum interleukin (IL)-6 and C-reactive protein (CRP) for the diagnosis of PJI. Methods PubMed, Embase, and the Web of Science databases were searched for articles describing PJI diagnosis using serum IL-6 and CRP published between January 1990 and December 2019. Results Eight studies were included in the meta-analysis. The pooled sensitivity was 0.84 (95% confidence interval [CI], 0.80−0.88) for the combined method (serum IL-6 and CRP) in series and parallel approaches, 0.87 (95% CI, 0.82−0.90) for IL-6, and 0.84 (95% CI, 0.79−0.88) for CRP. The pooled specificity was 0.85 (95% CI, 0.82−0.88) for the combined method, 0.83 (95% CI, 0.79−0.87) for IL-6, and 0.83 (95% CI, 0.79−0.87) for CRP. The combined method had the highest value for the area under the curve (0.9453), followed by IL-6 (0.9237) and CRP (0.9074). Subgroup analyses showed that the sensitivity of the combined method in parallel tests was higher than that in IL-6 or CRP (94% vs. 89% and 84%, respectively). Serial testing of the combined method showed increased specificity compared to a single indicator (96% vs. 83% and 80%). Conclusion The combination of serum IL-6 and CRP was a reliable tool for the diagnosis of periprosthetic hip and knee infection, demonstrating a better diagnostic accuracy than single marker analysis. |
topic |
Periprosthetic joint infection Arthroplasty Serum Interleukin-6 C-reactive protein Diagnosis |
url |
http://link.springer.com/article/10.1186/s13018-020-01864-7 |
work_keys_str_mv |
AT chengli iscombiningseruminterleukin6andcreactiveproteinareliablediagnostictoolinperiprostheticjointinfections AT christinaojedathies iscombiningseruminterleukin6andcreactiveproteinareliablediagnostictoolinperiprostheticjointinfections AT chixu iscombiningseruminterleukin6andcreactiveproteinareliablediagnostictoolinperiprostheticjointinfections AT andrejtrampuz iscombiningseruminterleukin6andcreactiveproteinareliablediagnostictoolinperiprostheticjointinfections |
_version_ |
1724741828568154112 |