Table 2.
Diagnostic Accuracy of Included Tests
| Test | Sensitivity | Specificity | NPV | PPV | LR+ | LR- | |
|---|---|---|---|---|---|---|---|
| Berthoud | Lactate/Glucose Ratio > 5 | 52.0% | 98.10% | 27 | 0.49 | ||
| Synovial Lactate >/=10 | 40.0% | 99.00% | 41.6 | 0.61 | |||
| Synovial Glucose < 1.0 | 32.0% | 99.00% | 33.3 | 0.69 | |||
| Sigmund | SF mPCR | 38.0% | 100.00% | 100 | 53.6 | 0 | 0.62 |
| Sf Culture | 29.0% | 100.00% | 100 | 50 | 0 | 0.71 | |
| Combined culture + mPCR | 43.0% | 100.00% | 100 | 55.6 | 0 | 0.57 | |
| Tissue Culture | 40.0% | 100.00% | 0 | 0.6 | |||
| Chouk | PCT > 0.5 ng/ml | 65.0% | 91.00% | 65 | 91 | 7.20 | 0.40 |
| PCT > 0.2 ng/ml | 80.0% | 74.40% | 44.4 | 93.5 | 3.10 | 0.30 | |
| Shu | Synovial Lactate >/=10 | 27.0% | 97.00% | 7.90 | 0.80 | ||
| Synovial Lactate >/= 5 | 55.0% | 76.00% | 2.30 | 0.60 | |||
| WBC >/= 50,000 | 27.0% | 97.00% | 7.90 | 0.80 | |||
| WBC >/=100,000 | 18.0% | 100.00% | 10.00 | 0.80 | |||
| Baillet | Calprotectin > 150 mg/L | 73.0% | 94.00% | 84 | 88 | 11.64 | 0.29 |
| Calprotectin < 52 mg/L | 96.0% | 44.00% | 47 | 95 | 1.71 | 0.09 | |
| Morgenstern | Serum CRP > 10 | 78.0% | 40.00% | 48 | 71 | 1.30 | 0.55 |
| Serum WBC > 10 | 62.0% | 74.00% | 65 | 71 | 2.38 | 0.51 | |
| SF Leuks > 50,000 or PMNs > 90% | 94.0% | 100.00% | 100 | 97 | 0.00 | 0.06 | |
| Culture | 46.0% | 100.00% | 100 | 74 | 0.00 | 0.54 | |
| PCR | 23.0% | 91.00% | 63 | 65 | 2.56 | 0.77 | |
| Microcalorimetry | 46.0% | 94.00% | 83 | 73 | 7.67 | 0.57 | |
| Pavic | Features of Sepsis (RR > 25 bpm, HR > 120 bpm, SBP < 100, temp > 38.5 w/I 24 h of review) | 75.0% | 72.10% | 24.7 | 93.5 | 1.93 | 0.41 |
| Ferreyra | Neutrophil count > 50,000 | 50.0% | 94.40% | 8.93 | 0.53 | ||
| Neutrophil count < 15,000 | 92.3% | 77.00% | 4.013 | 0.10 | |||
| Leukocyte count > 50,000 | 53.6% | 91.70% | 5.76 | 0.51 | |||
| Leukocyte count > 70,000 | 39.3% | 95.60% | 8.93 | 0.63 | |||
| Leukocyte count< 20,000 | 92.3% | 70.60% | 3.14 | 0.11 | |||
| %Neutrophils> 90 | 71.4% | 79.70% | 3.52 | 0.36 | |||
| %Neutrophils> 95 | 50.0% | 89.00% | 4.55 | 0.56 | |||
| %Neutrophils< 80 | 96.2% | 56.00% | 2.19 | 0.07 | |||
| %Neutrophils> 90 + no crystals | 67.9% | 92.80% | 8.28 | 0.35 | |||
| %Neutrophils> 95 + no crystals | 50.0% | 95.60% | 11.36 | 0.52 | |||
| > 50,000 leukocytes + no crystals | 53.6% | 95.10% | 10.94 | 0.49 | |||
| > 50,000 neutrophils + no crystals | 35.7% | 96.70% | 10.82 | 0.66 | |||
| Borzio | Synovial fluid WBC > 64,000 | 40.0% | 90.00% | 4 | 0.25 | ||
| Kocher criteria + synovial WBC > 64,000 | 0.0% | 98.60% | 0 | 90.8 | 0 | 1.01419878 | |
| Paosong | Procalcitonin >/= 0.66 | 59.0% | 86.00% | 69.9 | 79.6 | 4.21 | 0.48 |
| Lenski1 | Synovial tot prot 4.3 | 55.6% | 75.00% | 2.22 | 0.59 | ||
| Syn Gluc 40 | 56.6% | 83.00% | 3.33 | 0.52 | |||
| Synovial Lactate 6.2 | 74.5% | 87.20% | 5.81 | 0.29 | |||
| Syn WBC 14.4 | 71.2% | 84.90% | 4.71 | 0.34 | |||
| Synovial IL6 7000 | 92.5% | 64.10% | 2.58 | 0.12 | |||
| Omar | LE ++ or +++ | 94.7% | 73.20% | 34.6 | 98.9 | 3.54 | 0.08 |
| LE ++ or +++ and GLC - | 89.5% | 99.20% | 94.4 | 98.4 | 111.88 | 0.11 | |
| Baren | WBC > 50,000 | 72.7% | 92.30% | 9.09 | 0.30 | ||
| % PMNs> 90 | 81.8% | 67.30% | 2.50 | 0.27 | |||
| %PMNs> 85 | 88.6% | 57.70% | 2.05 | 0.23 | |||
| %PMNs> 80 | 93.2% | 53.80% | 2.32 | 0.11 | |||
| Lenski2 | Synovial lactate >/= 4.3 | 89.5% | 77.30% | 3.94 | 0.14 | ||
| Synovial Glucose< 51.5 | 65.9% | 92.00% | 8.24 | 0.37 | |||
| (Gout) (synovial uric acid of 7.0) | 78.1% | 82.80% | 4.53 | 0.27 | |||
| (Gout) (Serum uric acid of 7.2) | 70.00% | 85.20% | 4.73 | 0.35 | |||
| Synovial LDH>/=1900 | 68.9% | 88.90% | 6.2 | 0.35 | |||
| Synovial WBC>/=38.0 | 58.2% | 86.20% | 4.22 | 0.49 | |||
| Synovial total prot of>/=4.4 | 48.90% | 75.00% | 1.96 | 0.68 | |||
| Synovial IL-6 of>/=7000 | 93.90% | 13.60% | 1.09 | 0.44 | |||
| Serum CRP of>/=0.5 | 92.30% | 3.50% | 0.96 | 2.23 | |||
| Peripheral WBC>/=10.0 | 55.80% | 41.40% | 0.95 | 1.07 | |||
| Talebi-Taher | WBC > 50,000 | 100% | 66% | 59.52 | 100 | 2.94 | 0.00 |
| PMN > 75% | 100.00% | 94.00% | 89.29 | 100 | 16.67 | 0.00 | |
| CRP > 18 mg/L | 92.00% | 30% | 76.47 | 79.31 | 1.31 | 0.27 | |
| ESR (> 17 for men, > 25 for women) | 100.00% | 26.00% | 40.32 | 100 | 1.35 | 0.00 | |
| TNF-alpha > 10 | 96.00% | 62% | 55.81 | 96.88 | 2.58 | 0.06 | |
| IL6 > 20 | 12.00% | 92% | 42.86 | 67.65 | 1.50 | 0.96 | |
| Serum PCT > 0.5 ng/ml | 68.00% | 80.00% | 62.96 | 83.33 | 3.40 | 0.40 | |
| Synovial fluid PCT > 0.5%ng/ml | 24.00% | 96% | 75 | 71.64 | 6.00 | 0.79 |