Assessment of the Diagnostic Efficacy of C-Reactive Protein (CRP)/Albumin to Globulin Ratio (AGR) Test as a Good Diagnostic Tool for Periprosthetic Joint Infection

Description

Abstract (English)

Aim: To assess C-reactive protein (CRP)/albumin to globulin ratio (AGR) test as a good diagnostic tool for
periprosthetic joint infection.
Materials and Methods: This study was done in the department of Orthopaedics, SKMCH, Muzaffarpur, Bihar,
India for six months. The study design involved a retrospective analysis of clinical data obtained from patients
who were diagnosed with peri prosthetic joint infections. The collected data consists of various parameters such
as age, gender and pre-operatic serum markers including erythrocyte sedimentation rate (ESR), C-reactive protein
(CRP), globulin (GLB), Albumin to globulin ratio (A/G), CRP/AGR ratio.
Results: Among 30 patients 21 had positive culture results, 9 patients had negative culture results. Based on the
culture reports the most common organism involved is Staphylococcus aureus 85.71% followed by Staph.
Epidermidis 14.28%. Average values for culture sensitive CRP/AGR values 69 (Ranging from 29 to 96). Average
CRP value is 66.85 mg/L (ranging from 46 mg/L to 94 mg/L). ESR average value of 55mm/hr(ranging from 27
mm/hr to 98 mm/hr) . Average values for culture negative CRP/AGR 15.22 (ranging from 8 to 44). CRP average
value 15.77 mg/L ranging from (11 mg/L to 23 mg/L). ESR 32.77 mm/hr ranging from (27 mm/hr to 39 mm/hr).
For culture sensitive patients the diagnosing accuracy for in culture patients CRP is 91.75%, ESR is 69.46%,
CRP/AGR 93.75%, (whereas in culture negative the threshold for diagnosing accuracy for CRP is 60%, CRP/AGR
is 61%, ESR is 51%.
Conclusion: In conclusion, our findings indicate that the patients diagnosed with PJI (Periprosthetic joint
infection) exhibited significantly elevated levels of ESR, CRP, CRP/AGR. These biomarkers show promising
results for the diagnosis of PJI. However, when used alone, CRP/AGR demonstrated excellent diagnostic
performance, followed by CRP and ESR with good diagnostic performance.