Evaluating the utility of inflammatory markers in the diagnosis of soft tissue abscesses of the forearm and hand.

IF 1.8 Q3 INFECTIOUS DISEASES Journal of Bone and Joint Infection Pub Date : 2023-01-01 DOI:10.5194/jbji-8-119-2023
Sarah R Blumenthal, Adnan N Cheema, Steven E Zhang, Benjamin L Gray, Nikolas H Kazmers
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Abstract

Upper extremity abscesses frequently present to the acute care setting with inconclusive physical examination and imaging findings. We sought to investigate the diagnostic accuracy of inflammatory markers including white blood cell (WBC) count, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). A retrospective cohort study was performed to identify subjects 18  years treated with surgical debridement of upper extremity abscesses at our institution between January 2012 and December 2015. In this study, 188 patients were screened, and 72 met the inclusion criteria. A confirmed abscess as defined by culture positivity was present in 67 (93.1 %) cases. The sensitivity of WBC, ESR, or CRP individually was 0.45, 0.71, and 0.81. The specificity of WBC, ESR, or CRP individually was 0.80, 0.80, and 0.40. In combination all three markers when positive had a sensitivity of 0.26 and specificity of 1.0. These values were similar among patients with diabetes and those with obesity. With the highest sensitivity and lowest specificity, CRP exhibited the most utility as a screening test (level IV).

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评估炎症标志物在前臂和手部软组织脓肿诊断中的应用价值。
上肢脓肿经常出现在急症护理机构,体检和影像学结果不确定。我们试图研究炎症标志物的诊断准确性,包括白细胞(WBC)计数、红细胞沉降率(ESR)和c反应蛋白(CRP)。回顾性队列研究选取2012年1月至2015年12月在我院接受上肢脓肿手术清创治疗的年龄≥18岁的患者。本研究共筛选188例患者,其中72例符合纳入标准。经培养阳性确诊脓肿67例(93.1 %)。WBC、ESR和CRP的敏感性分别为0.45、0.71和0.81。WBC、ESR和CRP的特异性分别为0.80、0.80和0.40。三种标志物联合检测阳性时,敏感性为0.26,特异性为1.0。这些数值在糖尿病患者和肥胖患者中相似。CRP具有最高的敏感性和最低的特异性,是一种最实用的筛选试验(四级)。
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CiteScore
3.70
自引率
0.00%
发文量
29
审稿时长
12 weeks
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