Risk factors for periprosthetic joint infection after primary artificial hip and knee joint replacements

H, Guo; Xu, Chi; Chen, Jiying

doi:10.3855/jidc.11013

Cited by 18 publications

(22 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Deng et al (2019) also found a higher infection risk for patients with coronary artery disease ( p = 0.003) after spinal surgery and also found cardiovascular diseases as risk factor for the development of postoperative infections [ 26 ]. In addition to the risk factors already described in FRI, such as prolonged duration of surgery, in cases with PJI previous operations, smoking and BMI, peripheral blood circulation situation was also found to be particularly important [ 9 , 27 , 28 , 29 , 30 ]. In our investigation, in particular arterial hypertension and heart failure were associated with PJIs, and showed a relative risk between 5 to 6.5 compared to the general population.…”

Section: Discussionmentioning

confidence: 99%

“…In these patients, the duration of an operation is mostly prolonged, and soft tissue is characterized by reduced blood flow, while the patient themselves often suffer from further multiple comorbidities [ 9 , 30 ]. Consequently, an increased risk of infection following surgical procedures in orthopedic and trauma surgery with rates of up to 24% have been described in this difficult to treat patient group [ 9 , 12 , 27 , 28 , 30 ]. However, a BMI < 19 kg/m 2 has also been described in the literature as a risk factor and should always be considered in preoperative planning [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of Comorbidities as Risk Factors for Fracture-Related Infection and Periprosthetic Joint Infection in Germany

Szymski

Walter

Alt

et al. 2022

JCM

View full text Add to dashboard Cite

Introduction: Fracture-related infections (FRI) and periprosthetic joint infections (PJI) represent a major challenge in orthopedic surgery. Incidence of both entities is annually growing. Comorbidities play an important role as an influencing factor for infection and thus, for prevention and treatment strategies. The aims of this study were (1) to analyze the frequency of comorbidities in FRI and PJI patients and (2) to evaluate comorbidities as causative risk factor for PJI and FRI. Methods: This retrospective cohort study analysed all ICD-10 codes, which were coded as secondary diagnosis in all in hospital-treated FRI and PJI in the year 2019 in Germany provided by the Federal Statistical Office of Germany (Destatis). Prevalence of comorbidities was compared with the prevalence in the general population. Results: In the year 2019, 7158 FRIs and 16,174 PJIs were registered in Germany, with 68,304 comorbidities in FRI (mean: 9.5 per case) and 188,684 in PJI (mean: 11.7 per case). Major localization for FRI were infections in the lower leg (55.4%) and forearm (9.2%), while PJI were located mostly at hip (47.4%) and knee joints (45.5%). Mainly arterial hypertension (FRI: n = 3645; 50.9%—PJI: n = 11360; 70.2%), diabetes mellitus type II (FRI: n = 1483; 20.7%—PJI: n = 3999; 24.7%), obesity (FRI: n = 749; 10.5%—PJI: n = 3434; 21.2%) and chronic kidney failure (FRI: n = 877; 12.3%—PJI: n = 3341; 20.7%) were documented. Compared with the general population, an increased risk for PJI and FRI was reported in patients with diabetes mellitus (PJI: 2.988; FRI: 2.339), arterial hypertension (PJI: 5.059; FRI: 2.116) and heart failure (PJI: 6.513; FRI: 3.801). Conclusion: Patients with endocrinological and cardiovascular diseases, in particular associated with the metabolic syndrome, demonstrate an increased risk for orthopedic implant related infections. Based on the present results, further infection prevention and treatment strategies should be evaluated.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Evaluation of Comorbidities as Risk Factors for Fracture-Related Infection and Periprosthetic Joint Infection in Germany

Szymski

Walter

Alt

et al. 2022

JCM

View full text Add to dashboard Cite

show abstract

“…Among the Gram+ pathogens recorded, staphylococci were responsible for more than 50% of PJIs, streptococci and enterococci accounted for about 10% of all PJIs and fungi for about 1–2%; in line with the expected proportions of causative micro-organisms [ 4 , 45 , 46 , 70 , 71 ].…”

Section: Discussionmentioning

confidence: 66%

A retrospective study of risk factors, causative micro-organisms and healthcare resources consumption associated with prosthetic joint infections (PJI) using the Clinical Practice Research Datalink (CPRD) Aurum database

2023

View full text Add to dashboard Cite

Background Prosthetic joint infection (PJI) is a serious complication after joint replacement surgery and it is associated with risk of mortality and morbidity along with high direct costs. Methods The Clinical Practice Research Datalink (CPRD) data were utilized to quantify PJI incidence after hip or knee replacement up to 5 years after implant and a variety of risk factors related to patient characteristics, medical and treatment history along with characteristics of the original surgery were analyzed through Cox proportional hazard. Results 221,826 patients (individual joints 283,789) met all the inclusion and exclusion criteria of the study; during the study follow-up period (5 years), 707 and 695 PJIs were diagnosed in hip and knee, respectively. Patients undergoing joint replacement surgery during an unscheduled hospitalization had greater risk of PJI than patients whose surgery was elective; similarly, the risk of developing PJI after a secondary hip or knee replacement was about 4 times greater than after primary arthroplasty when adjusted for all other variables considered. A previous diagnosis of PJI, even in a different joint, increased the risk of a further PJI. Distribution of average LoS per each hospitalization caused by PJI exhibited a right skewed profile with median duration [IQR] duration of 16 days [8–32] and 13 days [7.25–32] for hip and knee, respectively. PJIs causative micro-organisms were dependent on the time between initial surgery and infection offset; early PJI were more likely to be multispecies than later (years after surgery); the identification of Gram- pathogens decreased with increasing post-surgery follow-up. Conclusions This study offers a contemporary assessment of the budgetary and capacity (number and duration of hospitalizations along with the number of Accident and Emergency (A&E) visits) posed by PJIs in UK for the national healthcare system (NHS). The results to provide risk management and planning tools to health providers and policy makers in order to fully assess technologies aimed at controlling and preventing PJI. The findings add to the existing evidence-based knowledge surrounding the epidemiology and burden of PJI by quantifying patterns of PJI in patients with a relatively broad set of prevalent comorbidities.

show abstract

“…BMI was included because of the known association between body mass index and postoperative infection. 29 All statistical analyses were conducted at alpha = 0.05.…”

Section: Methodsmentioning

confidence: 99%

What Are the Risk Factors for Infection After Operative Treatment of Peritalar Fracture Dislocations?

Levitt

Patch

Johnson

et al. 2022

Journal of Orthopaedic Trauma

View full text Add to dashboard Cite

Objective: To assess the risk factors associated with deep infection after operative treatment of peritalar fracture dislocations.Design: A retrospective study was performed to identify patients who had operative treatment of a peritalar fracture dislocation over an 11-year period (2008-2019).Setting: Level 1 trauma center.Participants: Patients were identified by review of all surgical billing that included open reduction of peritalar dislocation. Minimum follow-up for inclusion was 3 months or the outcome of interest. A total of 178 patients were identified, and 154 patients met inclusion criteria.Main Outcome: The primary outcome was deep infection, defined as return to the operating room for debridement with positive cultures.Results: A total of 19 (12.3%) patients developed a postoperative deep infection. The most common associated fractures were talus (47%), calcaneus (33%), and fibula (9%) fractures. The infected group was significantly older (47.2 vs. 39.5 years, P = 0.03). Patients undergoing operative management for peritalar fracture dislocations with current smoking were found to have significantly higher odds of postoperative deep infection (74 vs. 34%, adjusted odds ratio = 7.4, 95% confidence interval, 2.3-24.1, P = 0.001). There was a significantly higher risk of infection in patients with a Gustilo-Anderson type 3 open fracture (32 vs. 12%, adjusted odds ratio = 5.7, 95% confidence interval, 1.6-20.3, P = 0.007). The infected group had high rates of below knee amputation when compared with the group without infection (47 vs. 1%, P , 0.001). Conclusion:In our retrospective study, risk factors for infection after peritalar fracture dislocation included older age, smoking, and Gustilo-Anderson type 3 open fracture.

show abstract

Risk factors for periprosthetic joint infection after primary artificial hip and knee joint replacements

Cited by 18 publications

References 15 publications

Evaluation of Comorbidities as Risk Factors for Fracture-Related Infection and Periprosthetic Joint Infection in Germany

Evaluation of Comorbidities as Risk Factors for Fracture-Related Infection and Periprosthetic Joint Infection in Germany

A retrospective study of risk factors, causative micro-organisms and healthcare resources consumption associated with prosthetic joint infections (PJI) using the Clinical Practice Research Datalink (CPRD) Aurum database

What Are the Risk Factors for Infection After Operative Treatment of Peritalar Fracture Dislocations?

Contact Info

Product

Resources

About