Is combining serum interleukin-6 and C-reactive protein a reliable diagnostic tool in periprosthetic joint infections?
Arthroplasty
C-reactive protein
Diagnosis
Interleukin-6
Meta-analysis
Periprosthetic joint infection
Serum
Journal
Journal of orthopaedic surgery and research
ISSN: 1749-799X
Titre abrégé: J Orthop Surg Res
Pays: England
ID NLM: 101265112
Informations de publication
Date de publication:
02 Oct 2020
02 Oct 2020
Historique:
received:
21
03
2020
accepted:
06
08
2020
entrez:
3
10
2020
pubmed:
4
10
2020
medline:
26
5
2021
Statut:
epublish
Résumé
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. 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. 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%). 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.
Sections du résumé
BACKGROUND
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
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
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
CONCLUSIONS
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.
Identifiants
pubmed: 33008442
doi: 10.1186/s13018-020-01864-7
pii: 10.1186/s13018-020-01864-7
pmc: PMC7532114
doi:
Substances chimiques
Biomarkers
0
Interleukin-6
0
C-Reactive Protein
9007-41-4
Types de publication
Journal Article
Meta-Analysis
Langues
eng
Sous-ensembles de citation
IM
Pagination
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