RESUMO
Although low-sensitivity CRP (Ls-CRP) is an important tool for evaluating infected orthopedic prostheses, no clinical studies have evaluated whether Hs-CRP is a suitable surrogate for Ls-CRP or other traditional infection biomarkers. The laboratory data of 98 arthroplasty patients with suspected prosthetic infection were reviewed. Hs-CRP was highly correlated with Ls-CRP (R = 0.93). ROC analysis generated 100% sensitivity and 97% specificity for both Hs-CRP and Ls-CRP at optimal cutoffs of 28.6 and 2.6 mg/dL, respectively. Both CRP tests were more accurate than serum erythrocyte sedimentation rate, neutrophil differential, and white blood cell count. Hs-CRP was no different from Ls-CRP after unit conversion, and regression analyses suggested conversion factors that approximated 10. Hs-CRP and Ls-CRP have equivalent utility in the diagnosis of infected joint arthroplasty.
Assuntos
Proteína C-Reativa/análise , Infecções Relacionadas à Prótese/sangue , Infecções Relacionadas à Prótese/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Sedimentação Sanguínea , Feminino , Humanos , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Curva ROC , Sensibilidade e EspecificidadeRESUMO
BACKGROUND: Thanks to defense mechanisms, organisms have had to adapt themselves to an adverse natural setting that causes acute and chronic stress. This adaptive response that tries to protect the cells against lethal insults uses its own defense systems. MATERIAL AND METHODS: Prospective, observational, descriptive pilot study with analytic components to determine the baseline preoperative TNF levels of 35 patients undergoing total knee arthroplasty due to gonarthrosis. Ten patients with a diagnosis of infected total knee arthroplasty were also included. In order to find differences and possible associations, the Mann-Whitney U test or the Fisher test was used to compare the variables between the non-infected group of patients and the group with the infection complication. RESULTS: We found a statistically significant difference; higher levels of fibrinogen, erythrocyte sedimentation rate, C-reactive protein, TNF-alpha and temperature were found in the infected patients; temperature was not clinically relevant. CONCLUSIONS: In the absence of a diagnostic specificity, the combined determinations of acute phase reactants may be useful to detect the presence and intensity of the inflammatory and infectious processes.