Hypoalbuminemia increases the risk of failure following one-stage septic revision for periprosthetic joint infection
Purpose Malnutrition is a potentially modifiable risk factor of periprosthetic joint infection (PJI). The purpose of this study was to analyze the role of nutritional status as a risk factor for failure after one- stage revision hip or knee arthroplasty for PJI. Methods Retrospective, single-center,...
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| Veröffentlicht in: | Archives of orthopaedic and trauma surgery 2023-09, Vol.143 (9), p.5641-5648 |
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| creator | Traverso, Giacomo Núñez, Jorge H. Gehrke, Thorsten Citak, Mustafa |
| description | Purpose
Malnutrition is a potentially modifiable risk factor of periprosthetic joint infection (PJI). The purpose of this study was to analyze the role of nutritional status as a risk factor for failure after one- stage revision hip or knee arthroplasty for PJI.
Methods
Retrospective, single-center, case–control study. Patients with PJI according to the 2018 International Consensus Meeting criteria were evaluated. Minimum follow-up was 4 years. Total lymphocyte count (TLC), albumin values, hemoglobin, C-reactive protein, white blood cell (WBC) count and glucose levels were analyzed. An analysis was also made of the index of malnutrition. Malnutrition was defined as serum albumin |
| doi_str_mv | 10.1007/s00402-023-04885-z |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2802886945</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2802886945</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-c12b11f7fbac082857640f5871c938ad90365a5d9aa583253353650d82f715433</originalsourceid><addsrcrecordid>eNp9kUtv3SAQRlHVqnn1D3RRIXWTjdsBjMHLKmoeUqRskjXicodbbm1wwU6V_PqQ3PShLLICMWe-GXQI-cjgCwNQXwtAC7wBLhpotZbN_Ruyz1rRNqJn3dv_7nvkoJQtAOO6h_dkTyhQjPV8n8znd1Oyw2oZQ8QxWBqiy2gLFjr_QJpD-UmTp96GYclIfRqG9DvEDU0RmzLbDdKC0xwczXgbSkixMplOmMOUU6kZj7VtCnGu0R7dXJEj8s7boeCH5_OQ3Jx-vz45by6vzi5Ovl02Tig5N47xFWNe-ZV1oLmWqmvBS62Y64W26x5EJ61c99ZKLbgUQtYHWGvuFZOtEIfkeJdbV_m1YJnNGIrDYbAR01IM18C17vpWVvTzC3SblhzrdpWSXdcqqXWl-I5y9W8lozdTDqPNd4aBeXRidk5MdWKenJj72vTpOXpZjbj-2_JHQgXEDii1FDeY_81-JfYBnbiYfw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2856647588</pqid></control><display><type>article</type><title>Hypoalbuminemia increases the risk of failure following one-stage septic revision for periprosthetic joint infection</title><source>Springer Nature - Complete Springer Journals</source><creator>Traverso, Giacomo ; Núñez, Jorge H. ; Gehrke, Thorsten ; Citak, Mustafa</creator><creatorcontrib>Traverso, Giacomo ; Núñez, Jorge H. ; Gehrke, Thorsten ; Citak, Mustafa</creatorcontrib><description>Purpose
Malnutrition is a potentially modifiable risk factor of periprosthetic joint infection (PJI). The purpose of this study was to analyze the role of nutritional status as a risk factor for failure after one- stage revision hip or knee arthroplasty for PJI.
Methods
Retrospective, single-center, case–control study. Patients with PJI according to the 2018 International Consensus Meeting criteria were evaluated. Minimum follow-up was 4 years. Total lymphocyte count (TLC), albumin values, hemoglobin, C-reactive protein, white blood cell (WBC) count and glucose levels were analyzed. An analysis was also made of the index of malnutrition. Malnutrition was defined as serum albumin < 3.5 g/dL and TLC < 1500/mm
3.
Septic failure was defined as the presence of local or systemic symptoms of infection and the need of further surgery as a result of persistent PJI.
Results
No significant differences were found between increased failure rates after a one-stage revision hip or knee arthroplasty for PJI and TLC, hemoglobin level, WBC count, glucose levels, or malnutrition. Albumin and C-reactive protein values were found to have a positive and significant relationship with failure (p < 0.05). Multivariate logistic regression identified only hypoalbuminemia (serum albumin < 3.5 g/dL) (OR 5.64, 95% CI 1.26–25.18, p = 0.023) as a significant independent risk factor for failure. The receiver operating characteristic (ROC) curve for the model yielded an area under the curve of 0.67.
Conclusion
TLC, hemoglobin; WBC count; glucose levels; and malnutrition, understood as the combination of albumin and TLC, were not found to be statically significant risk factors for failure after single–stage revision for PJI. However, albumin < 3.5 g/dL, alone was a statically significant risk factor for failure after single-stage revision for PJI. As hypoalbuminemia seems to influence the failure rate, it is advisable to measure albumin levels in preoperative workups.</description><identifier>ISSN: 1434-3916</identifier><identifier>ISSN: 0936-8051</identifier><identifier>EISSN: 1434-3916</identifier><identifier>DOI: 10.1007/s00402-023-04885-z</identifier><identifier>PMID: 37071192</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Glucose ; Hemoglobin ; Infections ; Joint replacement surgery ; Malnutrition ; Medicine ; Medicine & Public Health ; Orthopaedic Surgery ; Orthopedics ; Risk factors</subject><ispartof>Archives of orthopaedic and trauma surgery, 2023-09, Vol.143 (9), p.5641-5648</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-c12b11f7fbac082857640f5871c938ad90365a5d9aa583253353650d82f715433</citedby><cites>FETCH-LOGICAL-c375t-c12b11f7fbac082857640f5871c938ad90365a5d9aa583253353650d82f715433</cites><orcidid>0000-0003-3815-100X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00402-023-04885-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00402-023-04885-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37071192$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Traverso, Giacomo</creatorcontrib><creatorcontrib>Núñez, Jorge H.</creatorcontrib><creatorcontrib>Gehrke, Thorsten</creatorcontrib><creatorcontrib>Citak, Mustafa</creatorcontrib><title>Hypoalbuminemia increases the risk of failure following one-stage septic revision for periprosthetic joint infection</title><title>Archives of orthopaedic and trauma surgery</title><addtitle>Arch Orthop Trauma Surg</addtitle><addtitle>Arch Orthop Trauma Surg</addtitle><description>Purpose
Malnutrition is a potentially modifiable risk factor of periprosthetic joint infection (PJI). The purpose of this study was to analyze the role of nutritional status as a risk factor for failure after one- stage revision hip or knee arthroplasty for PJI.
Methods
Retrospective, single-center, case–control study. Patients with PJI according to the 2018 International Consensus Meeting criteria were evaluated. Minimum follow-up was 4 years. Total lymphocyte count (TLC), albumin values, hemoglobin, C-reactive protein, white blood cell (WBC) count and glucose levels were analyzed. An analysis was also made of the index of malnutrition. Malnutrition was defined as serum albumin < 3.5 g/dL and TLC < 1500/mm
3.
Septic failure was defined as the presence of local or systemic symptoms of infection and the need of further surgery as a result of persistent PJI.
Results
No significant differences were found between increased failure rates after a one-stage revision hip or knee arthroplasty for PJI and TLC, hemoglobin level, WBC count, glucose levels, or malnutrition. Albumin and C-reactive protein values were found to have a positive and significant relationship with failure (p < 0.05). Multivariate logistic regression identified only hypoalbuminemia (serum albumin < 3.5 g/dL) (OR 5.64, 95% CI 1.26–25.18, p = 0.023) as a significant independent risk factor for failure. The receiver operating characteristic (ROC) curve for the model yielded an area under the curve of 0.67.
Conclusion
TLC, hemoglobin; WBC count; glucose levels; and malnutrition, understood as the combination of albumin and TLC, were not found to be statically significant risk factors for failure after single–stage revision for PJI. However, albumin < 3.5 g/dL, alone was a statically significant risk factor for failure after single-stage revision for PJI. As hypoalbuminemia seems to influence the failure rate, it is advisable to measure albumin levels in preoperative workups.</description><subject>Glucose</subject><subject>Hemoglobin</subject><subject>Infections</subject><subject>Joint replacement surgery</subject><subject>Malnutrition</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Orthopaedic Surgery</subject><subject>Orthopedics</subject><subject>Risk factors</subject><issn>1434-3916</issn><issn>0936-8051</issn><issn>1434-3916</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNp9kUtv3SAQRlHVqnn1D3RRIXWTjdsBjMHLKmoeUqRskjXicodbbm1wwU6V_PqQ3PShLLICMWe-GXQI-cjgCwNQXwtAC7wBLhpotZbN_Ruyz1rRNqJn3dv_7nvkoJQtAOO6h_dkTyhQjPV8n8znd1Oyw2oZQ8QxWBqiy2gLFjr_QJpD-UmTp96GYclIfRqG9DvEDU0RmzLbDdKC0xwczXgbSkixMplOmMOUU6kZj7VtCnGu0R7dXJEj8s7boeCH5_OQ3Jx-vz45by6vzi5Ovl02Tig5N47xFWNe-ZV1oLmWqmvBS62Y64W26x5EJ61c99ZKLbgUQtYHWGvuFZOtEIfkeJdbV_m1YJnNGIrDYbAR01IM18C17vpWVvTzC3SblhzrdpWSXdcqqXWl-I5y9W8lozdTDqPNd4aBeXRidk5MdWKenJj72vTpOXpZjbj-2_JHQgXEDii1FDeY_81-JfYBnbiYfw</recordid><startdate>20230901</startdate><enddate>20230901</enddate><creator>Traverso, Giacomo</creator><creator>Núñez, Jorge H.</creator><creator>Gehrke, Thorsten</creator><creator>Citak, Mustafa</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3815-100X</orcidid></search><sort><creationdate>20230901</creationdate><title>Hypoalbuminemia increases the risk of failure following one-stage septic revision for periprosthetic joint infection</title><author>Traverso, Giacomo ; Núñez, Jorge H. ; Gehrke, Thorsten ; Citak, Mustafa</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-c12b11f7fbac082857640f5871c938ad90365a5d9aa583253353650d82f715433</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Glucose</topic><topic>Hemoglobin</topic><topic>Infections</topic><topic>Joint replacement surgery</topic><topic>Malnutrition</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Orthopaedic Surgery</topic><topic>Orthopedics</topic><topic>Risk factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Traverso, Giacomo</creatorcontrib><creatorcontrib>Núñez, Jorge H.</creatorcontrib><creatorcontrib>Gehrke, Thorsten</creatorcontrib><creatorcontrib>Citak, Mustafa</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of orthopaedic and trauma surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Traverso, Giacomo</au><au>Núñez, Jorge H.</au><au>Gehrke, Thorsten</au><au>Citak, Mustafa</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hypoalbuminemia increases the risk of failure following one-stage septic revision for periprosthetic joint infection</atitle><jtitle>Archives of orthopaedic and trauma surgery</jtitle><stitle>Arch Orthop Trauma Surg</stitle><addtitle>Arch Orthop Trauma Surg</addtitle><date>2023-09-01</date><risdate>2023</risdate><volume>143</volume><issue>9</issue><spage>5641</spage><epage>5648</epage><pages>5641-5648</pages><issn>1434-3916</issn><issn>0936-8051</issn><eissn>1434-3916</eissn><abstract>Purpose
Malnutrition is a potentially modifiable risk factor of periprosthetic joint infection (PJI). The purpose of this study was to analyze the role of nutritional status as a risk factor for failure after one- stage revision hip or knee arthroplasty for PJI.
Methods
Retrospective, single-center, case–control study. Patients with PJI according to the 2018 International Consensus Meeting criteria were evaluated. Minimum follow-up was 4 years. Total lymphocyte count (TLC), albumin values, hemoglobin, C-reactive protein, white blood cell (WBC) count and glucose levels were analyzed. An analysis was also made of the index of malnutrition. Malnutrition was defined as serum albumin < 3.5 g/dL and TLC < 1500/mm
3.
Septic failure was defined as the presence of local or systemic symptoms of infection and the need of further surgery as a result of persistent PJI.
Results
No significant differences were found between increased failure rates after a one-stage revision hip or knee arthroplasty for PJI and TLC, hemoglobin level, WBC count, glucose levels, or malnutrition. Albumin and C-reactive protein values were found to have a positive and significant relationship with failure (p < 0.05). Multivariate logistic regression identified only hypoalbuminemia (serum albumin < 3.5 g/dL) (OR 5.64, 95% CI 1.26–25.18, p = 0.023) as a significant independent risk factor for failure. The receiver operating characteristic (ROC) curve for the model yielded an area under the curve of 0.67.
Conclusion
TLC, hemoglobin; WBC count; glucose levels; and malnutrition, understood as the combination of albumin and TLC, were not found to be statically significant risk factors for failure after single–stage revision for PJI. However, albumin < 3.5 g/dL, alone was a statically significant risk factor for failure after single-stage revision for PJI. As hypoalbuminemia seems to influence the failure rate, it is advisable to measure albumin levels in preoperative workups.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>37071192</pmid><doi>10.1007/s00402-023-04885-z</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-3815-100X</orcidid></addata></record> |
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| source | Springer Nature - Complete Springer Journals |
| subjects | Glucose Hemoglobin Infections Joint replacement surgery Malnutrition Medicine Medicine & Public Health Orthopaedic Surgery Orthopedics Risk factors |
| title | Hypoalbuminemia increases the risk of failure following one-stage septic revision for periprosthetic joint infection |
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