Relationship between the clinical outcomes and the systemic inflammatory response index and systemic immune inflammation index after total knee arthroplasty.
Periprosthetic joint infection
Systemic inflammation immune index
Systemic inflammatory response index
Total knee arthroplasty
Journal
Musculoskeletal surgery
ISSN: 2035-5114
Titre abrégé: Musculoskelet Surg
Pays: Italy
ID NLM: 101498346
Informations de publication
Date de publication:
19 Jun 2024
19 Jun 2024
Historique:
received:
15
03
2024
accepted:
07
05
2024
medline:
20
6
2024
pubmed:
20
6
2024
entrez:
19
6
2024
Statut:
aheadofprint
Résumé
Periprosthetic joint infection (PJI) is an extremely damaging complication that can occur after total knee arthroplasty (TKA). There is no study in the literature investigating the relationship between systemic inflammatory response index (SIRI) and systemic inflammation immune index (SII) values and prognosis and infection in patients who have undergone TKA. The aim of the study was to determine the relationship between the inflammatory index values and the rate of PJI in patients who had previously had TKA. A total of 187 patients who underwent TKA between 2015 and 2023 years were retrospectively analyzed. The median value of the postoperative SII index was 1862.3 (1146.6-2630.4) in the infected group, while it was 1058.2 (605.0-1762.8) in the non-infected group (p < 0.001). In the infected group, the median value of preoperative SIRI was observed as 2.3 (1.7-3.5), while in the non-infected group it was 0.9 (0.7-1.5) (p < 0.001). The cutoff value for postoperative SIRI was observed to be 2.19, with a sensitivity value of 95%, a specificity value of 46%, the AUC value observed was 65%. The cutoff value for the postoperative SII index was observed to be 1058.96, with a sensitivity value of 100%, a specificity value of 50%. Our study has associated the inflammatory markers SIRI, SII, neutrophil lymphocyte ratio, and platelet lymphocyte ratio with PJI, which are easy and inexpensive to obtain. There is no widely recognized serum biomarker that can be used alone with good sensitivity and specificity. This study contributes to finding the gold standard inflammatory marker for diagnosing PJI.
Sections du résumé
BACKGROUND
BACKGROUND
Periprosthetic joint infection (PJI) is an extremely damaging complication that can occur after total knee arthroplasty (TKA). There is no study in the literature investigating the relationship between systemic inflammatory response index (SIRI) and systemic inflammation immune index (SII) values and prognosis and infection in patients who have undergone TKA. The aim of the study was to determine the relationship between the inflammatory index values and the rate of PJI in patients who had previously had TKA.
METHODS
METHODS
A total of 187 patients who underwent TKA between 2015 and 2023 years were retrospectively analyzed.
RESULTS
RESULTS
The median value of the postoperative SII index was 1862.3 (1146.6-2630.4) in the infected group, while it was 1058.2 (605.0-1762.8) in the non-infected group (p < 0.001). In the infected group, the median value of preoperative SIRI was observed as 2.3 (1.7-3.5), while in the non-infected group it was 0.9 (0.7-1.5) (p < 0.001). The cutoff value for postoperative SIRI was observed to be 2.19, with a sensitivity value of 95%, a specificity value of 46%, the AUC value observed was 65%. The cutoff value for the postoperative SII index was observed to be 1058.96, with a sensitivity value of 100%, a specificity value of 50%.
CONCLUSIONS
CONCLUSIONS
Our study has associated the inflammatory markers SIRI, SII, neutrophil lymphocyte ratio, and platelet lymphocyte ratio with PJI, which are easy and inexpensive to obtain. There is no widely recognized serum biomarker that can be used alone with good sensitivity and specificity. This study contributes to finding the gold standard inflammatory marker for diagnosing PJI.
Identifiants
pubmed: 38898343
doi: 10.1007/s12306-024-00825-1
pii: 10.1007/s12306-024-00825-1
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024. The Author(s), under exclusive licence to Istituto Ortopedico Rizzoli.
Références
Sinno E, Panegrossi G, Rovere G, Cavallo AU, Falez F (2023) Influence of posterior tibial slope on postoperative outcomes after postero-stabilized and condylar-stabilized total knee arthroplasty. Musculoskelet Surg 107:385–390. https://doi.org/10.1007/s12306-022-00768-5
doi: 10.1007/s12306-022-00768-5
pubmed: 36370251
Kurtz SM, Lau E, Schmier J, Ong KL, Zhao K, Parvizi J (2008) Infection burden for hip and knee arthroplasty in the United States. J Arthroplasty 23:984–991. https://doi.org/10.1016/j.arth.2007.10.017
doi: 10.1016/j.arth.2007.10.017
pubmed: 18534466
Tande AJ, Patel R (2014) Prosthetic joint infection. Clin Microbiol Rev 27:302–345. https://doi.org/10.1128/CMR.00111-13
doi: 10.1128/CMR.00111-13
pubmed: 24696437
pmcid: 3993098
Sculco TP (1995) The economic impact of infected joint arthroplasty. Orthopedics 18:871–873
pubmed: 8570494
Koh CK, Zeng I, Ravi S, Zhu M, Vince KG, Young SW (2017) Periprosthetic joint infection is the main cause of failure for modern knee arthroplasty: an analysis of 11,134 knees. Clin Orthop Relat Res 475:2194–2201. https://doi.org/10.1007/s11999-017-5396-4
doi: 10.1007/s11999-017-5396-4
pubmed: 28573549
pmcid: 5539036
Jenny JY (2020) Specificities of total hip and knee arthroplasty revision for infection. Orthop Traumatol Surg Res OTSR 106:S27–S34. https://doi.org/10.1016/j.otsr.2019.05.020
doi: 10.1016/j.otsr.2019.05.020
pubmed: 31813779
Mussa M, Manciulli T, Corbella M, Mariani B, Cambieri P, Gipsz N, Scudeller L, Abbott DM, Brunetti E, Mosconi M, Benazzo F, Orsolini P (2021) Epidemiology and microbiology of prosthetic joint infections: a nine-year, single-center experience in Pavia, Northern Italy. Musculoskelet Surg 105:195–200. https://doi.org/10.1007/s12306-020-00638-y
doi: 10.1007/s12306-020-00638-y
pubmed: 31993973
Rondon AJ, Tan TL, Parvizi J (2018) Serological markers of infection in the infected total knee arthroplasty. Infect Total Knee Arthroplasty Prevent Diagn Treat. https://doi.org/10.1007/978-3-319-66730-0_9
doi: 10.1007/978-3-319-66730-0_9
Chao B, Ju X, Zhang L, Xu X, Zhao Y (2020) A novel prognostic marker systemic inflammation response index (SIRI) for operable cervical cancer patients. Front Oncol 10:766. https://doi.org/10.3389/fonc.2020.00766
doi: 10.3389/fonc.2020.00766
pubmed: 32477958
pmcid: 7237698
Pacheco-Barcia V, Mondéjar Solís R, France T, Asselah J, Donnay O, Zogopoulos G, Bouganim N, Guo K, Rogado J, Martin E, Alcindor T, Colomer R (2020) A systemic inflammation response index (SIRI) correlates with survival and predicts oncological outcome for mFOLFIRINOX therapy in metastatic pancreatic cancer. Pancreatology 20:254–264. https://doi.org/10.1016/j.pan.2019.12.010
doi: 10.1016/j.pan.2019.12.010
pubmed: 31866391
Erre GL, Buscetta G, Mangoni AA, Castagna F, Paliogiannis P, Oggiano M, Carru C, Passiu G, Zinellu A (2020) Diagnostic accuracy of different blood cells-derived indexes in rheumatoid arthritis: a cross-sectional study. Medicine 99:e22557. https://doi.org/10.1097/MD.0000000000022557
doi: 10.1097/MD.0000000000022557
pubmed: 33126304
pmcid: 7598803
Aziz MH, Sideras K, Aziz NA, Mauff K, Haen R, Roos D, Saida L, Suker M, van der Harst E, Mieog JS, Bonsing BA, Klaver Y, Koerkamp BG, van Eijck CH (2019) The systemic-immune-inflammation index independently predicts survival and recurrence in resectable pancreatic cancer and its prognostic value depends on bilirubin levels: a retrospective multicenter cohort study. Ann Surg 270:139–146. https://doi.org/10.1097/SLA.0000000000002660
doi: 10.1097/SLA.0000000000002660
pubmed: 29334554
Ye Z, Hu T, Wang J, Xiao R, Liao X, Liu M, Sun Z (2022) Systemic immune-inflammation index as a potential biomarker of cardiovascular diseases: a systematic review and meta-analysis. Front Cardiovasc Med 9:933913. https://doi.org/10.3389/fcvm.2022.933913
doi: 10.3389/fcvm.2022.933913
pubmed: 36003917
pmcid: 9393310
Trifan G, Testai FD (2020) Systemic Immune-Inflammation (SII) index predicts poor outcome after spontaneous supratentorial intracerebral hemorrhage. J Stroke Cerebrovasc Dis 29:105057. https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105057
doi: 10.1016/j.jstrokecerebrovasdis.2020.105057
pubmed: 32807462
International Consensus Group (ICM) The Second International Consensus Meeting (ICM) on orthopaedic infections. https://icmphilly.com/general-assembly
Lattanzi S, Norata D, Divani AA, Di Napoli M, Broggi S, Rocchi C, Ortega-Gutierrez S, Mansueto G, Silvestrini M (2021) Systemic inflammatory response index and futile recanalization in patients with ischemic stroke undergoing endovascular treatment. Brain Sci 11:1164. https://doi.org/10.3390/brainsci11091164
doi: 10.3390/brainsci11091164
pubmed: 34573185
pmcid: 8468021
Wang X, Ni Q, Wang J, Wu S, Chen P, Xing D (2022) Systemic inflammation response index is a promising prognostic marker in elderly patients with heart failure: a retrospective cohort study. Front Cardiovasc Med 9:871031. https://doi.org/10.3389/fcvm.2022.871031
doi: 10.3389/fcvm.2022.871031
pubmed: 35911534
pmcid: 9330028
Zhao Y, Hong X, Xie X, Guo D, Chen B, Fu W, Wang L (2022) Preoperative systemic inflammatory response index predicts long-term outcomes in type B aortic dissection after endovascular repair. Front Immunol 13:992463. https://doi.org/10.3389/fimmu.2022.992463
doi: 10.3389/fimmu.2022.992463
pubmed: 36248781
pmcid: 9554789
Cui S, Cao S, Chen Q, He Q, Lang R (2023) Preoperative systemic inflammatory response index predicts the prognosis of patients with hepatocellular carcinoma after liver transplantation. Front Immunol 14:1118053. https://doi.org/10.3389/fimmu.2023.1118053
doi: 10.3389/fimmu.2023.1118053
pubmed: 37051235
pmcid: 10083266
Yang YL, Wu CH, Hsu PF, Chen SC, Huang SS, Chan WL, Lin SJ, Chou CY, Chen JW, Pan JP, Charng MJ, Chen YH, Wu TC, Lu TM, Huang PH, Cheng HM, Huang CC, Sung SH, Lin YJ, Leu HB (2020) Systemic immune-inflammation index (SII) predicted clinical outcome in patients with coronary artery disease. Eur J Clin Investig 50:e13230. https://doi.org/10.1111/eci.13230
doi: 10.1111/eci.13230
Cetinkaya Z, Kelesoglu S (2023) The role of pan-immune-inflammation value in predicting contrast-induced nephropathy development in patients undergoing percutaneous coronary intervention due to NSTEMI. Angiology. https://doi.org/10.1177/00033197231211107
doi: 10.1177/00033197231211107
pubmed: 37903550
Hu B, Yang XR, Xu Y, Sun YF, Sun C, Guo W, Zhang X, Wang WM, Qiu SJ, Zhou J, Fan J (2014) Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clin Cancer Res 20:6212–6222. https://doi.org/10.1158/1078-0432.CCR-14-0442
doi: 10.1158/1078-0432.CCR-14-0442
pubmed: 25271081
Fang H, Zhang H, Wang Z, Zhou Z, Li Y, Lu L (2020) Systemic immune-inflammation index acts as a novel diagnostic biomarker for postmenopausal osteoporosis and could predict the risk of osteoporotic fracture. J Clin Lab Anal 34:e23016. https://doi.org/10.1002/jcla.23016
doi: 10.1002/jcla.23016
pubmed: 31423643
Tetreault MW, Wetters NG, Moric M, Gross CE, Della Valle CJ (2014) Is synovial C-reactive protein a useful marker for periprosthetic joint infection? Clin Orthop Relat Res 472:3997–4003. https://doi.org/10.1007/s11999-014-3828-y
doi: 10.1007/s11999-014-3828-y
pubmed: 25070920
pmcid: 4397770
Shahi A, Kheir MM, Tarabichi M, Hosseinzadeh HRS, Tan TL, Parvizi J (2017) Serum D-dimer test is promising for the diagnosis of periprosthetic joint infection and timing of reimplantation. J Bone Jt Surg Am 99:1419–1427. https://doi.org/10.2106/JBJS.16.01395
doi: 10.2106/JBJS.16.01395
Wyatt MC, Beswick AD, Kunutsor SK, Wilson MJ, Whitehouse MR, Blom AW (2016) The alpha-defensin immunoassay and leukocyte esterase colorimetric strip test for the diagnosis of periprosthetic infection: a systematic review and meta-analysis. J Bone Jt Surg Am 98:992–1000. https://doi.org/10.2106/JBJS.15.01142
doi: 10.2106/JBJS.15.01142
Deirmengian C, Kardos K, Kilmartin P, Cameron A, Schiller K, Parvizi J (2014) Combined measurement of synovial fluid α-Defensin and C-reactive protein levels: highly accurate for diagnosing periprosthetic joint infection. J Bone Jt Surg Am 96:1439–1445. https://doi.org/10.2106/JBJS.M.01316
doi: 10.2106/JBJS.M.01316
Lee YS, Koo KH, Kim HJ, Tian S, Kim TY, Maltenfort MG, Chen AF (2017) Synovial fluid biomarkers for the diagnosis of periprosthetic joint infection: a systematic review and meta-analysis. J Bone Jt Surg Am 99:2077–2084. https://doi.org/10.2106/JBJS.17.00123
doi: 10.2106/JBJS.17.00123
Parvizi J, Tan TL, Goswami K, Higuera C, Della Valle C, Chen AF, Shohat N (2018) The 2018 Definition of periprosthetic hip and knee infection: an evidence-based and validated criteria. J Arthroplasty 33:1309-1314.e2. https://doi.org/10.1016/j.arth.2018.02.078
doi: 10.1016/j.arth.2018.02.078
pubmed: 29551303
Wang RH, Wen WX, Jiang ZP, Du ZP, Ma ZH, Lu AL, Li HP, Yuan F, Wu SB, Guo JW, Cai YF, Huang Y, Wang LX, Lu HJ (2023) The clinical value of neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), platelet-to-lymphocyte ratio (PLR) and systemic inflammation response index (SIRI) for predicting the occurrence and severity of pneumonia in patients with intracerebral hemorrhage. Front Immunol 14:1115031. https://doi.org/10.3389/fimmu.2023.1115031
doi: 10.3389/fimmu.2023.1115031
pubmed: 36860868
pmcid: 9969881
Fois AG, Paliogiannis P, Scano V, Cau S, Babudieri S, Perra R, Ruzzittu G, Zinellu E, Pirina P, Carru C, Arru LB, Fancellu A, Mondoni M, Mangoni AA, Zinellu A (2020) The systemic inflammation index on admission predicts in-hospital mortality in COVID-19 patients. Molecules (Basel, Switzerland) 25:5725. https://doi.org/10.3390/molecules25235725
doi: 10.3390/molecules25235725
pubmed: 33291581
Lu W, Lin S, Wang C, Jin P, Bian J (2023) The potential value of systemic inflammation response index on delirium after hip arthroplasty surgery in older patients: a retrospective study. Int J Gen Med 16:5355–5362. https://doi.org/10.2147/IJGM.S427507
doi: 10.2147/IJGM.S427507
pubmed: 38021071
pmcid: 10676096
Menger MD, Vollmar B (2004) Surgical trauma: hyperinflammation versus immunosuppression? Langenbecks Arch Surg 389:475–484. https://doi.org/10.1007/s00423-004-0472-0
doi: 10.1007/s00423-004-0472-0
pubmed: 15173946
Mimasaka S, Funayama M, Hashiyada M, Nata M, Tsunenari S (2007) Significance of levels of IL-6 and IL-8 after trauma: a study of 11 cytokines post-mortem using multiplex immunoassay. Injury 38:1047–1051. https://doi.org/10.1016/j.injury.2007.02.045
doi: 10.1016/j.injury.2007.02.045
pubmed: 17574251
de Jager CP, van Wijk PT, Mathoera RB, de Jongh-Leuvenink J, van der Poll T, Wever PC (2010) Lymphocytopenia and neutrophil-lymphocyte count ratio predict bacteremia better than conventional infection markers in an emergency care unit. Crit Care (Lond, Engl) 14:R192. https://doi.org/10.1186/cc9309
doi: 10.1186/cc9309
Fisher A, Srikusalanukul W, Fisher L, Smith P (2016) The neutrophil to lymphocyte ratio on admission and short-term outcomes in orthogeriatric patients. Int J Med Sci 13:588–602. https://doi.org/10.7150/ijms.15445
doi: 10.7150/ijms.15445
pubmed: 27499691
pmcid: 4974907
Yombi JC, Schwab PE, Thienpont E (2016) 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 24:3287–3292. https://doi.org/10.1007/s00167-015-3921-0
doi: 10.1007/s00167-015-3921-0
pubmed: 26704797
Domagalska M, Reysner T, Kowalski G, Daroszewski P, Mularski A, Wieczorowska-Tobis K (2023) Pain management, functional recovery, and stress response expressed by NLR and PLR after the iPACK block combined with adductor canal block for total knee arthroplasty-a prospective, randomised, double-blinded clinical trial. J Clin Med 12:7088. https://doi.org/10.3390/jcm12227088
doi: 10.3390/jcm12227088
pubmed: 38002702
pmcid: 10672046
Barker T, Rogers VE, Brown KB, Henriksen VT, Rasmussen GL (2017) Tourniquet use during total knee arthroplasty does not modulate the neutrophil-to-lymphocyte ratio, pain, or activity. J Orthop Traumatol 18:283–287. https://doi.org/10.1007/s10195-016-0435-6
doi: 10.1007/s10195-016-0435-6
pubmed: 27848053
Melinte RM, Arbănași EM, Blesneac A, Zolog DN, Kaller R, Mureșan AV, Arbănași EM, Melinte IM, Niculescu R, Russu E (2022) Inflammatory biomarkers as prognostic factors of acute deep vein thrombosis following the total knee arthroplasty. Medicina (Kaunas) 58:1502. https://doi.org/10.3390/medicina58101502
doi: 10.3390/medicina58101502
pubmed: 36295662
Feng D, Wang D, Gu C, Lv M, Liu Z, Wang Y (2023) Effectiveness of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in predicting the incidence of nausea and vomiting after total knee arthroplasty in patients with hemophilia A. Front Surg 10:1120930. https://doi.org/10.3389/fsurg.2023.1120930
doi: 10.3389/fsurg.2023.1120930
pubmed: 37139191
pmcid: 10149928
Tirumala V, Klemt C, Xiong L, Chen W, van den Kieboom J, Kwon YM (2021) Diagnostic utility of platelet count/lymphocyte count ratio and platelet count/mean platelet volume ratio in periprosthetic joint infection following total knee arthroplasty. J Arthroplasty 36:291–297. https://doi.org/10.1016/j.arth.2020.07.038
doi: 10.1016/j.arth.2020.07.038
pubmed: 32773272