Risk factors differ for Gram-negative surgical site infection following hip and knee arthroplasty: an observational study from a national surveillance system.
N Z Med J
; 135(1550): 47-61, 2022 02 25.
Article
em En
| MEDLINE
| ID: mdl-35728152
ABSTRACT
AIM:
To describe risk factors for surgical site infection (SSI) caused by aerobic Gram-negative organisms after hip and knee arthroplasty.METHOD:
Publicly funded hip and knee arthroplasties (performed between 1 July 2013 and 31 December 2017) that developed SSIs were compared to those that did not. SSIs were grouped by causative organism Gram-negative (Pseudomonas spp. or enteric Gram-negative bacilli) or staphylococcal (pure or mixed growth of Staphylococcus spp.). Independent risk factors in each group were identified.RESULTS:
24,842 (54%) hip and 20,993 (46%) knee arthroplasties were performed. There were 497 (1.1%) SSIs. Staphylococci were responsible for 233 SSIs (47%) and Gram-negatives were responsible for 73 (15%). Age, sex, body mass index ≥35kg/m2, smoking status, socioeconomic deprivation, American Society of Anesthesiologists classification, revision surgery and prophylactic antibiotic dose were all independent predictors of all-cause SSI. On subgroup analysis, socioeconomic deprivation and Pasifika ethnicity were independent risk factors for Gram-negative SSI, but not staphylococcal SSI.DISCUSSION:
In this study, socioeconomic deprivation and ethnicity were independent and novel risk factors for Gram-negative SSI following arthroplasty. Some of the SSI risk factors can be modified before arthroplasty (e.g., appropriate timing of prophylactic antibiotics, smoking cessation, weight loss). Non-modifiable risk factors can help identify high-risk procedures where additional pre- and post-operative interventions may be warranted.
Buscar no Google
Base de dados:
MEDLINE
Assunto principal:
Artroplastia de Quadril
/
Artroplastia do Joelho
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Limite:
Humans
País como assunto:
Oceania
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article