Fibrosis in Hepatitis C Patients Predicts Complications After Elective Total Joint Arthroplasty

Orozco, Fabio; Post, Zachary D.; Baxi, Omkar; Miller, Adam; Ong, Alvin

doi:10.1016/j.arth.2013.03.023

Cited by 45 publications

(24 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This is similar to the report by Moon et al[16], who also found THA patients with cirrhosis had significantly greater risk of bleeding, coagulopathy, and infection. Surgical wound disruption was significantly more common in cirrhotic patients who underwent TKA, which is similar to the results of Orozco et al[25]. …”

Section: Discussionsupporting

confidence: 88%

Impact of Cirrhosis on Resource Use and Inpatient Complications in Patients Undergoing Total Knee and Hip Arthroplasty

Newman

Schiltz

Mudd

et al. 2016

The Journal of Arthroplasty

View full text Add to dashboard Cite

Background Cirrhosis is a major cause of morbidity and mortality and is an important risk factor for complications in surgical patients. The purpose of this study was to investigate the association of cirrhosis with postoperative complications, length of stay (LOS), and costs among patients who underwent total knee (TKA) or hip (THA) arthroplasty. Methods Using the Nationwide Inpatient Sample between 2000 and 2011, we identified patients who had a primary TKA or primary THA. TKA patients were divided into two groups: 1) cirrhosis (n= 41,464) and 2) no cirrhosis (n= 5,721,297) and THA patients were divided into two groups: 1) cirrhosis (n= 27,401) and 2) no cirrhosis (n= 2,622,539). Patient demographics, comorbidities, perioperative complications, LOS, incremental costs were analyzed. An additional subgroup analysis by cirrhosis etiology was performed. Results Multivariable analysis revealed cirrhosis was associated with 1.55 (95%CI: 1.47–1.63) times higher odds of any complication after TKA, and 1.59 (1.50–1.69) higher odds after THA. Adjusted outcomes showed cirrhotic TKA patients had $1,857 higher costs and 0.30 days longer LOS, and THA cirrhotic patients had $1,497 higher costs and 0.48 longer LOS. We found similar results for each cirrhosis subtype, but alcohol-related had the highest resource use and complication rate. Conclusion Patients with cirrhosis who are undergoing TKA or THA are at a significantly increased risk for perioperative complications, increased LOS and higher costs. The perioperative complications and costs were highest among patients with alcohol-related cirrhosis.

show abstract

Section: Discussionsupporting

confidence: 88%

Impact of Cirrhosis on Resource Use and Inpatient Complications in Patients Undergoing Total Knee and Hip Arthroplasty

Newman

Schiltz

Mudd

et al. 2016

The Journal of Arthroplasty

View full text Add to dashboard Cite

show abstract

“…In our review of the literature we identified five studies that evaluated periprosthetic joint infections after TJAs in patients with cirrhosis that combined for a total of 149 patients [4,10,19,20,26]. The reported rates of periprosthetic joint infections vary from 6% (n = 3/51) [26], 8% (n = 2/25) [20], and 10% (n = 3/30) [19], and as much as 29% (n = 2/7) [4].…”

Section: Discussionmentioning

confidence: 99%

“…The reported rates of periprosthetic joint infections vary from 6% (n = 3/51) [26], 8% (n = 2/25) [20], and 10% (n = 3/30) [19], and as much as 29% (n = 2/7) [4]. The results of our study, which identified more than 2000 patients with cirrhosis, confirm that patients with cirrhosis have increased risk of periprosthetic joint infections, with 6-month rates of 2.7% for patients undergoing TKAs, 3.7% for patients with nonhip fractures undergoing THAs, and 6.3% for patients with hip fractures undergoing THAs.…”

Section: Discussionmentioning

confidence: 99%

“…Current literature evaluating the results of TJA in patients with cirrhosis has been limited to small case series with groups of less than 100 patients [4,10,19,20,26]. In general these studies agreed that patients with cirrhosis had higher rates of periprosthetic joint infections, but given the small number of patients, there was limited evaluation of risk factors.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Increased Rates of Periprosthetic Joint Infection in Patients With Cirrhosis Undergoing Total Joint Arthroplasty

Jiang

Schairer

Bozic

2014

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…Orozco et al recently published a case control study to analyze the effect of fibrosis and thrombocytopenia on the diagnosis of hepatitis C and clinical outcomes. Analyzing 72 patients (77 joint replacements), the authors found that fibrotic hepatitis C patients had higher deep infection rates (21% vs 0%, P = 0.047) and rates of cellulitis (21% vs 0%, P = 0.047), while thromobocytopenia showed a trend towards greater infection (23).…”

Section: Resultsmentioning

confidence: 99%

Antibiotic Prophylaxis in Periprosthetic Joint Infection (PJI): literature Review and World Consensus (Part Seven)

Parvızı

Ghazavi

2016

Shafa Ortho J

View full text Add to dashboard Cite

Context: There is a need to find if patients with poorly controlled diabetes, immunosuppression, or autoimmune disease require different perioperative antibiotic prophylaxis. There is also a need to determine if antibiotic prophylaxis should be different for primary cases, revision cases, hip arthroplasty and knee arthroplasty. The best antibiotic prophylaxis to choose in patients with colonization by carbapenem resistant enterobacteriaceae or multi-drug resistant (MDR)-Acinetobacter spp needs to be determined. Evidence Acquisition: Delegates in workgroup 3 of the consensus meeting on PJI reviewed English literature for relevant articles. 30 of 221 articles were relevant to the 4 following questions regarding perioperative antibiotic prophylaxis to prevent PJI. Results: There is no need to use different antibiotic prophylaxis for patients with poorly controlled diabetes, immunosuppression, or autoimmune disease than routine antibiotic prophylaxis. Perioperative antibiotic prophylaxis should be the same for primary and uninfected revision arthroplasty. Perioperative antibiotic prophylaxis should be the same for hips and knees arthroplasties. There is insufficient data to recommend expanded antibiotic prophylaxis in patients known to be colonized or recently infected with multi-drug resistant pathogens. Conclusions: Based on evidences in the literature and consensus of expert delegates from consensus meeting recommendations for type of antibiotic prophylaxis in patients with poorly controlled diabetes, immunosuppression, or autoimmune disease, primary and uninfected revision arthroplasty, hip or knee arthroplasties and patients known to be colonized or recently infected with multidrug resistant pathogens were provided.

show abstract

Fibrosis in Hepatitis C Patients Predicts Complications After Elective Total Joint Arthroplasty

Cited by 45 publications

References 14 publications

Impact of Cirrhosis on Resource Use and Inpatient Complications in Patients Undergoing Total Knee and Hip Arthroplasty

Impact of Cirrhosis on Resource Use and Inpatient Complications in Patients Undergoing Total Knee and Hip Arthroplasty

Increased Rates of Periprosthetic Joint Infection in Patients With Cirrhosis Undergoing Total Joint Arthroplasty

Antibiotic Prophylaxis in Periprosthetic Joint Infection (PJI): literature Review and World Consensus (Part Seven)

Contact Info

Product

Resources

About