Tags

Type your tag names separated by a space and hit enter

Has the rate of in-hospital infections after total joint arthroplasty decreased?
Clin Orthop Relat Res. 2013 Oct; 471(10):3102-11.CO

Abstract

BACKGROUND

Although infections are a major cause of morbidity and mortality after total joint arthroplasty (TJA), little is known about nationwide epidemiology and trends of infections after TJA.

QUESTIONS/PURPOSES

We therefore determined (1) trends of postoperative pneumonia, urinary tract infection (UTI), surgical site infection (SSI), sepsis, and severe sepsis after TJA; (2) risk factors of these infections; (3) effect of these infections on length of stay (LOS) and hospital charges; and (4) the infection-related mortality rate and its predictors.

METHODS

The International Classification of Diseases, 9th Revision codes were used to identify patients who underwent TJA and were diagnosed with aforementioned infections during hospitalization in the Nationwide Inpatient Sample database from 2002 to 2010. Multivariate analysis was performed to identify risk factors of these infections.

RESULTS

Rates of pneumonia, UTI, SSI, sepsis, and severe sepsis were 0.74%, 3.26%, 0.31%, 0.25%, and 0.15%, respectively. Number of comorbidities and type of TJA were independent predictors of infection. Mortality decreased during the study period (odds ratio, 0.87; 95% confidence interval, 0.86-0.89). The median LOS was 3 days without complications but increased in the presence of SSI (median, 7 days), sepsis (median, 12 days), and severe sepsis (median, 15 days). Occurrence of pneumonia, sepsis, and severe sepsis increased risk of mortality 5.2, 8.5, and 66.2 times, respectively.

CONCLUSIONS

Rates of UTI, pneumonia, and SSI but not sepsis and severe sepsis are apparently decreasing. The likelihood of infection is increasing with number of comorbidities and revision surgeries. Rate of sepsis-related mortality is also decreasing.

LEVEL OF EVIDENCE

Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

Authors+Show Affiliations

The Rothman Institute of Orthopedics at Thomas Jefferson Hospital, 925 Chestnut Street, Philadelphia, PA, 19107, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23575808

Citation

Rasouli, Mohammad R., et al. "Has the Rate of In-hospital Infections After Total Joint Arthroplasty Decreased?" Clinical Orthopaedics and Related Research, vol. 471, no. 10, 2013, pp. 3102-11.
Rasouli MR, Maltenfort MG, Purtill JJ, et al. Has the rate of in-hospital infections after total joint arthroplasty decreased? Clin Orthop Relat Res. 2013;471(10):3102-11.
Rasouli, M. R., Maltenfort, M. G., Purtill, J. J., Hozack, W. J., & Parvizi, J. (2013). Has the rate of in-hospital infections after total joint arthroplasty decreased? Clinical Orthopaedics and Related Research, 471(10), 3102-11. https://doi.org/10.1007/s11999-013-2949-z
Rasouli MR, et al. Has the Rate of In-hospital Infections After Total Joint Arthroplasty Decreased. Clin Orthop Relat Res. 2013;471(10):3102-11. PubMed PMID: 23575808.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Has the rate of in-hospital infections after total joint arthroplasty decreased? AU - Rasouli,Mohammad R, AU - Maltenfort,Mitchell Gil, AU - Purtill,James J, AU - Hozack,William J, AU - Parvizi,Javad, PY - 2013/4/12/entrez PY - 2013/4/12/pubmed PY - 2013/12/16/medline SP - 3102 EP - 11 JF - Clinical orthopaedics and related research JO - Clin Orthop Relat Res VL - 471 IS - 10 N2 - BACKGROUND: Although infections are a major cause of morbidity and mortality after total joint arthroplasty (TJA), little is known about nationwide epidemiology and trends of infections after TJA. QUESTIONS/PURPOSES: We therefore determined (1) trends of postoperative pneumonia, urinary tract infection (UTI), surgical site infection (SSI), sepsis, and severe sepsis after TJA; (2) risk factors of these infections; (3) effect of these infections on length of stay (LOS) and hospital charges; and (4) the infection-related mortality rate and its predictors. METHODS: The International Classification of Diseases, 9th Revision codes were used to identify patients who underwent TJA and were diagnosed with aforementioned infections during hospitalization in the Nationwide Inpatient Sample database from 2002 to 2010. Multivariate analysis was performed to identify risk factors of these infections. RESULTS: Rates of pneumonia, UTI, SSI, sepsis, and severe sepsis were 0.74%, 3.26%, 0.31%, 0.25%, and 0.15%, respectively. Number of comorbidities and type of TJA were independent predictors of infection. Mortality decreased during the study period (odds ratio, 0.87; 95% confidence interval, 0.86-0.89). The median LOS was 3 days without complications but increased in the presence of SSI (median, 7 days), sepsis (median, 12 days), and severe sepsis (median, 15 days). Occurrence of pneumonia, sepsis, and severe sepsis increased risk of mortality 5.2, 8.5, and 66.2 times, respectively. CONCLUSIONS: Rates of UTI, pneumonia, and SSI but not sepsis and severe sepsis are apparently decreasing. The likelihood of infection is increasing with number of comorbidities and revision surgeries. Rate of sepsis-related mortality is also decreasing. LEVEL OF EVIDENCE: Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence. SN - 1528-1132 UR - https://www.unboundmedicine.com/medline/citation/23575808/Has_the_rate_of_in_hospital_infections_after_total_joint_arthroplasty_decreased L2 - https://link.springer.com/article/10.1007/s11999-013-2949-z DB - PRIME DP - Unbound Medicine ER -