Evidence map›Paper›PMID 41331588›Full record

ArticleJournal of orthopaedic surgery and research2025

Low prognostic nutritional index is highly associated with periprosthetic joint infection in revision arthroplasty: a 14-year retrospective cohort study.

Xuming Chen, Kang Yu, Wei Yao, Yangming Zhang, Qiyu Xie, Duan Wang, Hong Xu, Zongke Zhou

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Article in Journal of orthopaedic surgery and research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Xuming Chen *Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, No.37, Guoxue Road, Wuhou District, Chengdu, 610041, Sichuan, People's Republic of China.
Kang Yu *Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, No.37, Guoxue Road, Wuhou District, Chengdu, 610041, Sichuan, People's Republic of China.
Wei YaoDepartment of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, No.37, Guoxue Road, Wuhou District, Chengdu, 610041, Sichuan, People's Republic of China.
Yangming ZhangDepartment of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, No.37, Guoxue Road, Wuhou District, Chengdu, 610041, Sichuan, People's Republic of China.
Qiyu XieDepartment of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, No.37, Guoxue Road, Wuhou District, Chengdu, 610041, Sichuan, People's Republic of China.
Duan WangDepartment of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, No.37, Guoxue Road, Wuhou District, Chengdu, 610041, Sichuan, People's Republic of China.
Hong XuDepartment of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, No.37, Guoxue Road, Wuhou District, Chengdu, 610041, Sichuan, People's Republic of China. xuhongvip@yeah.net.
Zongke ZhouDepartment of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, No.37, Guoxue Road, Wuhou District, Chengdu, 610041, Sichuan, People's Republic of China. zhouzongke@scu.edu.cn.

Funding

1.3.5 Project for disciplines of excellence, West China Hospital, Sichuan University 2023HXFH0121.3.5 Project for disciplines of excellence, West China Hospital, Sichuan University No. 2023HXFH012National Key Research and Development Program of China 2022YFC2503100 and 2022YFC2503104National Key Research and Development Program of China No. 2022YFC2503100 and 2022YFC2503104Postdoctoral Fellowship Program of CPSF GZC20231825Postdoctoral Fellowship Program of CPSF No. GZC20231825Science and Technology Department of Sichuan Province 2024NSFSC1813Science and Technology Department of Sichuan Province No. 2024NSFSC1813
6 · The paper itself

Abstract

backgroundThe relationship between preoperative nutritional status and periprosthetic joint infection (PJI) remains unclear in patients undergoing revision arthroplasty. This study aimed to investigate (1) whether preoperative nutritional status influences the risk of PJI in these patients, and (2) to determine the optimal threshold for risk stratification.

methodsA retrospective cohort study involved 1,117 patients who underwent hip or knee revision between January 2011 and September 2024. Prognostic nutritional index (PNI) was calculated based on serum albumin and lymphocyte counts. Multivariate logistic regression, propensity score matching (PSM), restricted cubic spline (RCS) modeling, and Kaplan-Meier analysis were used to assess the association between PNI and PJI.

resultsAmong 1,117 patients, 40 (3.58%) developed PJI. Low levels of preoperative PNI (< 45.00) were significantly associated with an increased risk of re-revision due to PJI (adjusted odds ratio = 7.40, 95% CI: 3.49 ~ 15.72, P < 0.001). The incidence of re-revision for PJI was significantly higher in patients with lower preoperative PNI (8.31% vs. 1.21%, p < 0.001). Propensity score matching further confirmed these findings. The optimal threshold for preoperative PNI control was identified as 45.00, below which the risk of re-revision for PJI increased significantly.

conclusionLower PNI is independently associated with increased re-revision for PJI risk after revision arthroplasty. Maintaining preoperative PNI above 45.00 may help reduce the risk of re-revision for PJI.

Indexed as

Arthroplasty, Replacement, HipArthroplasty, Replacement, KneeNutritional StatusNutrition AssessmentProsthesis-Related InfectionsReoperationAgedAged, 80 and overCohort StudiesFemaleHumansMaleMiddle AgedPrognosisPropensity ScoreRetrospective StudiesPeriprosthetic joint infectionPrognostic nutritional indexRevision arthroplastyRisk stratification

Identifiers

PMID41331588
PMCPMC12777145

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LicenceCC BY-NC-ND
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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.