Mortality During Total Knee Periprosthetic Joint Infection.
J Arthroplasty
; 33(12): 3783-3788, 2018 12.
Article
in En
| MEDLINE
| ID: mdl-30224099
ABSTRACT
BACKGROUND:
Periprosthetic joint infections (PJIs) are fraught with multiple complications including poor patient-reported outcomes, disability, reinfection, disarticulation, and even death. We sought to perform a systematic review asking the question (1) What is the mortality rate of a PJI of the knee undergoing 2-stage revision for infection? (2) Has this rate improved over time? (3) How does this compare to a normal cohort of individuals?METHODS:
We performed a database search in MEDLINE/EMBASE, PubMed, and all relevant reference studies using the following keywords "periprosthetic joint infection," "mortality rates," "total knee arthroplasty," and "outcomes after two stage revision." Two hundred forty-two relevant studies and citations were identified, and 14 studies were extracted and included in the review.RESULTS:
A total of 20,719 patients underwent 2-stage revision for total knee PJI. Average age was 66 years. Mean mortality percentage reported was 14.4% (1.7%-34.0%) with average follow-up 3.8 years (0.25-9 years). One-year mortality rate was 4.33% (3.14%-5.51%) after total knee PJI with an increase of 3.13% per year mortality thereafter (r = 0.76 [0.49, 0.90], P < .001). Five-year mortality was 21.64%. When comparing the national age-adjusted mortality (Actuarial Life Table) and the reported 1-year mortality risk in this meta-analysis, the risk of death after total knee PJI is significantly increased, with an odds ratio of 3.05 (95% confidence interval, 2.69-3.44; P < .001).CONCLUSION:
The mortality rate after 2-stage total knee revision for infection is very high. When counseling a patient regarding complications of this disease, death should be discussed.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Reoperation
/
Arthritis, Infectious
/
Prosthesis-Related Infections
/
Arthroplasty, Replacement, Knee
Type of study:
Etiology_studies
/
Systematic_reviews
Aspects:
Patient_preference
Limits:
Humans
Language:
En
Journal:
J Arthroplasty
Journal subject:
ORTOPEDIA
Year:
2018
Document type:
Article
Affiliation country: