ArticleBMC musculoskeletal disorders2026
Association of preoperative D-dimer-to-albumin ratio and prognostic nutritional index with aseptic wound complications and periprosthetic joint infection after primary total knee arthroplasty: a single-center retrospective cohort study.
Article in BMC musculoskeletal disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
Abstract
objectiveTo investigate the associations of the preoperative D-dimer-to-albumin ratio (DAR) and prognostic nutritional index (PNI) with aseptic wound complications (AWC) and periprosthetic joint infection (PJI) after primary total knee arthroplasty (TKA), and to evaluate their within-sample discrimination for distinct postoperative adverse outcomes.
methodsThis single-center retrospective cohort study included patients who underwent primary unilateral TKA at the Affiliated Hospital of Qingdao University between April 2019 and January 2024. Patients with both AWC and PJI were classified in the PJI group only. Deep venous thrombosis was excluded preoperatively using lower-extremity color Doppler ultrasonography. DAR and PNI were calculated from laboratory tests obtained within 48 h before surgery. AWC was assessed within 30 days after surgery, and PJI was assessed within 2 years according to the 2018 International Consensus Meeting criteria. Multivariable logistic regression, receiver operating characteristic (ROC) analysis with 95% confidence intervals (CIs), DeLong tests, bootstrap internal validation, calibration assessment, and sensitivity analyses were performed.
resultsA total of 1,197 patients were included, including 45 isolated AWC events and 35 PJI events. After adjustment for age, sex, body mass index, diabetes mellitus, and Charlson Comorbidity Index, preoperative PNI was independently associated with isolated AWC (odds ratio [OR], 0.613; 95% CI, 0.543-0.693; P < 0.001), whereas preoperative DAR was not associated with isolated AWC (OR, 0.952; 95% CI, 0.852-1.064; P = 0.388). In contrast, DAR was independently associated with PJI (OR, 1.454; 95% CI, 1.328-1.592; P < 0.001), whereas PNI was not significantly associated with PJI (OR, 0.915; 95% CI, 0.825-1.015; P = 0.094). PNI showed an AUC of 0.873 (95% CI, 0.792-0.955) for isolated AWC, and DAR showed an AUC of 0.920 (95% CI, 0.865-0.975) for PJI. Bootstrap optimism-corrected AUCs were 0.862 for the adjusted PNI-AWC model and 0.900 for the adjusted DAR-PJI model.
conclusionsIn this exploratory single-center retrospective cohort, preoperative PNI was more strongly associated with isolated AWC, whereas preoperative DAR was more strongly associated with PJI. Although both markers showed good apparent discrimination and high negative predictive values, the low event numbers, limited positive predictive values, imperfect calibration, and absence of external validation require cautious interpretation. Larger multicenter prospective studies are needed before these cutoffs can be applied as clinical decision thresholds.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.