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

Jiang, Shirley L.; Schairer, William W.; Bozic, Kevin J.

doi:10.1007/s11999-014-3593-y

Cited by 73 publications

(45 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our study found that patients with cirrhosis in both the THA and TKA groups had increased odds of developing acute postoperative anemia, thrombocytopenia, hematoma/hemorrhage, acute renal failure, device-related complications, infection, and complications of medical care. In a study that utilized a statewide database, Jiang et al[12] studied the periprosthetic joint infection rate in patients with cirrhosis and found that infections were significantly more common in patients with cirrhosis compared to those controls after THA (3.7% vs. 0.7%, p<0.001) and TKA (2.7% vs. 0.8%, p<0.001). The cirrhosis patients also had significantly increased LOS, readmission, reoperation, mortality and costs.…”

Section: Discussionmentioning

confidence: 99%

“…Yet, patients with cirrhosis who undergo elective surgery have compensated cirrhosis[11]. Over the past decade, as the medical care for cirrhosis has improved and the number of patients living with cirrhosis increases[2], there has been an increase in the number of cirrhotic patients undergoing primary total joint arthroplasty (TJA)[12]. Complications due to cirrhosis following total hip arthroplasty (THA) and total knee arthroplasty (TKA) can lead to an increased risk of perioperative morbidity and mortality[8,13].…”

Section: Introductionmentioning

confidence: 99%

“…Complications due to cirrhosis following total hip arthroplasty (THA) and total knee arthroplasty (TKA) can lead to an increased risk of perioperative morbidity and mortality[8,13]. Several studies have reported on the outcomes of patients with cirrhosis following TJA[12–16], however, the population-level variation in complications by etiology of cirrhosis is not known.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

“…While worse outcomes have been documented among patients with liver cirrhosis undergoing primary total hip (THA) and knee (TKA) arthroplasty [14,15], the influence of alcohol misuse, without cirrhosis, on perioperative outcomes following total joint arthroplasty is poorly understood. One study by Williams-Russo et al [16] evaluated 60 patients undergoing bilateral TKA and found that pre-operative alcohol use was associated with an increased risk of delirium in geriatric patients.…”

mentioning

confidence: 99%

Alcohol Misuse is an Independent Risk Factor for Poorer Postoperative Outcomes Following Primary Total Hip and Total Knee Arthroplasty

Best

Buller

Gösthe

et al. 2015

The Journal of Arthroplasty

View full text Add to dashboard Cite

“…Also, patients with liver cirrhosis readmitted because of PJI had an increased rate of mortality (0.7% compared with 4.4%; P ¼ 0.003). 40 …”

Section: Identification Of Risk Factors For Pjimentioning

confidence: 99%

Periprosthetic joint infection in total knee arthroplasty

Gómez

Parvızı

2015

Current Orthopaedic Practice

View full text Add to dashboard Cite

Periprosthetic joint infection (PJI) is currently one of the three main causes of readmission and the most frequent cause of revision following total knee arthroplasty (TKA). It remains the most challenging complication in adult joint reconstruction due to the difficulty in diagnosis and treatment. This review article provides an update on the most recent developments related to the field which include the introduction of a novel biomarker for diagnosis of PJI, a summary of the international consensus meeting on PJI, and other developments.

show abstract

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

Abstract: Background Total joint arthroplasty (TJA) is becoming more prevalent, with additional increases in procedure rates expected as the US population ages.

Cited by 73 publications

References 26 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

Alcohol Misuse is an Independent Risk Factor for Poorer Postoperative Outcomes Following Primary Total Hip and Total Knee Arthroplasty

Periprosthetic joint infection in total knee arthroplasty

Contact Info

Product

Resources

About