Evidence map›Paper›PMID 37874358›Full record

ArticleArchives of orthopaedic and trauma surgery2024

Neutrophil-Lymphocyte Ratio and Lymphocyte-Monocyte Ratio correlate with Chronic Prosthetic Joint Infection but are not useful markers for diagnosis.

Daniel Timothy Burchette, Mustafa Fatih Dasci, Beatriz Fernandez Maza, Philip Linke, Thorsten Gehrke, Mustafa Citak

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In one paragraph

Article in Archives of orthopaedic and trauma surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
2.2field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 4 countries.

Daniel Timothy BurchetteENDO-Klinik Hamburg, Holstenstr. 2, 22767, Hamburg, Germany. daniel.burchette@nhs.net.ORCID http://orcid.org/0000-0002-2958-7277
Mustafa Fatih DasciENDO-Klinik Hamburg, Holstenstr. 2, 22767, Hamburg, Germany.
Beatriz Fernandez MazaENDO-Klinik Hamburg, Holstenstr. 2, 22767, Hamburg, Germany.ORCID http://orcid.org/0000-0003-2095-5982
Philip LinkeENDO-Klinik Hamburg, Holstenstr. 2, 22767, Hamburg, Germany.ORCID http://orcid.org/0000-0002-0770-5957
Thorsten GehrkeENDO-Klinik Hamburg, Holstenstr. 2, 22767, Hamburg, Germany.ORCID http://orcid.org/0000-0001-6897-2971
Mustafa CitakENDO-Klinik Hamburg, Holstenstr. 2, 22767, Hamburg, Germany.ORCID http://orcid.org/0000-0003-3207-7101
Helios Endo-Klinik Hamburg · DEBağcılar Eğitim ve Araştırma Hastanesi · TRHospital Universitario Puerta de Hierro Majadahonda · ESRoyal National Orthopaedic Hospital · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo investigate reported correlations between Neutrophil-to-Lymphocyte (NLR) and Lymphocyte-to-Monocyte (LMR) ratios and their value in diagnosis of chronic prosthetic joint infection (PJI) in a large cohort of patients from a single specialist hospital.

methodsDiagnostic aspirations of 362 patients under investigation for PJI were identified. Of the included patients 185 patients received a final diagnosis of PJI and 177 were classed as aseptic. Established criteria (ICM 2018) were employed to define PJI. Included in the analysis are differential white cell counts, C-Reactive Protein (CRP), Synovial Leukocyte Count, Synovial Alpha-defensin ELISA and Synovial Leukocyte esterase activity. Receiver-operator characteristic (ROC) curves were calculated for each of the available diagnostic tests together with the corresponding area under the curve values (AUC). Youden's index was utilized to identify the optimal diagnostic threshold point for the NLR and LMR. Other diagnostic tests were evaluated as per the threshold values previously defined in the literature and specified in the ICM criteria.

resultsUsing Youden's Index to identify the optimal NLR cut-off within our cohort we established a value of 2.93. This yielded a sensitivity of 0.60 and specificity of 0.64. The area under the curve (AUC) of a receiving operator characteristics (ROC) curve was 0.625. Regarding the LMR the results demonstrate similar findings; a positive correlation with a diagnosis of infection but poor sensitivity and specificity. The AUC for LMR was 0.633 and was not superior to NLR (P = 0.753).

conclusionsThere is a significant correlation between higher Neutrophil-Lymphocyte and Lymphocyte-Monocyte ratios, and a diagnosis of PJI. The sensitivity and specificity of this calculation is poor and the does not add value to the diagnostic algorithm for PJI. LEVEL OF EVIDENCE: Level III Retrospective Cohort analysis.

Indexed as

Arthritis, InfectiousArthroplasty, Replacement, HipProsthesis-Related InfectionsBiomarkersC-Reactive ProteinHumansLymphocytesMonocytesNeutrophilsRetrospective StudiesSensitivity and SpecificitySynovial FluidBiomarkersC-Reactive ProteinLymphocyte–monocyte ratioNeutrophil–lymphocyte ratioPeriprosthetic joint infection

Identifiers

PMID37874358
OpenAlexW4387893815

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.