{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:21:28Z","timestamp":1760145688839,"version":"build-2065373602"},"reference-count":25,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T00:00:00Z","timestamp":1724284800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Background: Periprosthetic joint infections (PJIs) are associated with altered coagulation dynamics; therefore, coagulation laboratory studies could be valuable for diagnosing PJI. This study aimed to evaluate the diagnostic role of Rotational Thromboelastometry (ROTEM) in detecting PJIs caused by low-virulence pathogens. Methods: A retrospective study was conducted, enrolling 78 patients who underwent exchange arthroplasty due to PJI due to high-virulence pathogens (Group A, n = 16), low-virulence pathogens (Group B, n = 20), or due to aseptic loosening (Group C, n = 20). Preoperative laboratory findings were compared among the three groups. Results: Several ROTEM parameters differed in patients with PJIs caused by low-virulence pathogens, indicating a link between these infections and hypercoagulability. The development of low-virulence PJIs was associated with a higher maximum clot firmness (MCF) (Odds Ratio, 1.12; 95% Confidence Interval, 1.04\u20131.21; p = 0.001). Additionally, EXTEM MCF was found to have the highest diagnostic accuracy for these infections (Area Under the Curve, 0.841; sensitivity 90.0%; specificity 90.4%), surpassing that of C-reactive protein and the Erythrocyte Sedimentation Rate (p = 0.006 and p = 0.019, respectively). Conclusions: Our findings suggest that ROTEM analysis is a promising method for detecting the altered hemostatic dynamics associated with PJI caused by low-virulence pathogens.<\/jats:p>","DOI":"10.3390\/microorganisms12081740","type":"journal-article","created":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T11:14:41Z","timestamp":1724325281000},"page":"1740","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic Accuracy of Rotational Thromboelastometry for Low-Virulence Periprosthetic Joint Infections: A Pilot Study"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3695-0759","authenticated-orcid":false,"given":"Andreas G.","family":"Tsantes","sequence":"first","affiliation":[{"name":"Laboratory of Haematology and Blood Bank Unit, \u201cAttiko\u201d Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece"},{"name":"Microbiology Department, \u201cSaint Savvas\u201d Oncology Hospital, 11522 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0141-4718","authenticated-orcid":false,"given":"Aglaia","family":"Domouchtsidou","sequence":"additional","affiliation":[{"name":"Microbiology Department, \u201cSaint Savvas\u201d Oncology Hospital, 11522 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantina A.","family":"Tsante","sequence":"additional","affiliation":[{"name":"Laboratory of Haematology and Blood Bank Unit, \u201cAttiko\u201d Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1082-5674","authenticated-orcid":false,"given":"Petros","family":"Ioannou","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine & Infectious Diseases, University General Hospital of Heraklion, 71110 Heraklion, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9833-8477","authenticated-orcid":false,"given":"Alexandra","family":"Mpakosi","sequence":"additional","affiliation":[{"name":"Department of Microbiology, General Hospital of Nikaia \u201cAgios Panteleimon\u201d, 18454 Piraeus, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eleni","family":"Petrou","sequence":"additional","affiliation":[{"name":"Laboratory of Haematology and Blood Bank Unit, \u201cAttiko\u201d Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stavros","family":"Goumenos","sequence":"additional","affiliation":[{"name":"First Department of Orthopaedics, School of Medicine, National and Kapodistrian University of Athens, 15771 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4759-4814","authenticated-orcid":false,"given":"Ioannis G.","family":"Trikoupis","sequence":"additional","affiliation":[{"name":"First Department of Orthopaedics, School of Medicine, National and Kapodistrian University of Athens, 15771 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anastasios G.","family":"Roustemis","sequence":"additional","affiliation":[{"name":"First Department of Orthopaedics, School of Medicine, National and Kapodistrian University of Athens, 15771 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sotirios P.","family":"Fortis","sequence":"additional","affiliation":[{"name":"Laboratory of Reliability and Quality Control in Laboratory Hematology (HemQcR), Department of Biomedical Sciences, Section of Medical Laboratories, School of Health & Caring Sciences, University of West Attica (UniWA), 12244 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1398-9626","authenticated-orcid":false,"given":"Christos","family":"Koutserimpas","sequence":"additional","affiliation":[{"name":"Orthopaedics Surgery and Sports Medicine Department, FIFA Medical Centre of Excellence, Croix-Rousse Hospital, Lyon University Hospital, 69004 Lyon, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Panayiotis J.","family":"Papagelopoulos","sequence":"additional","affiliation":[{"name":"First Department of Orthopaedics, School of Medicine, National and Kapodistrian University of Athens, 15771 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Samonis","sequence":"additional","affiliation":[{"name":"Metropolitan Hospital, Neon Faliron, 18547 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6102-6579","authenticated-orcid":false,"given":"Stefanos","family":"Bonovas","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University, 20072 Milan, Italy"},{"name":"IRCCS Humanitas Research Hospital, 20089 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dimitrios V.","family":"Papadopoulos","sequence":"additional","affiliation":[{"name":"Second Department of Orthopaedics, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Romano, C.L., Khawashki, H.A., Benzakour, T., Bozhkova, S., Del Sel, H., Hafez, M., Johari, A., Lob, G., Sharma, H.K., and Tsuchiya, H. 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