Wu Chuanlong, Qu Xinhua, Liu Fengxiang, Li Huiwu, Mao Yuanqing, Zhu Zhenan
Department of Orthopaedics, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
PLoS One. 2014 Apr 18;9(4):e95300. doi: 10.1371/journal.pone.0095300. eCollection 2014.
The purpose of this hospital-based case-control study was to evaluate the risk factors for periprosthetic joint infection (PJI) of total hip arthroplasty (THA) and total knee arthroplasty (TKA) in Chinese patients.
From January 2000 to December 2012, 45 patients undergoing THA and TKA who developed PJI were recruited for case subjects; controls were 252 without PJI, matched by year of index for surgery and type of surgery. Conditional logistic regressions were run to compute odds ratios (ORs) and 95% confidence intervals (CIs).
Demographic factors and comorbid conditions associated with an increased adjusted risk of PJI (in decreasing order of significance) were diabetes (OR = 5.47, 95% CI: 1.77-16.97; p = 0.003), age (65-75 vs. 45-65 years) (OR = 3.36, 95% CI: 1.30-8.69; p = 0.013), BMI (≥28 vs. 18.5-28 kg/m2) (OR = 2.77, 95% CI: 1.20-6.40; p = 0.017), place of residence (rural) (OR = 2.63, 95% CI: 1.13-6.10; p = 0.025) and alcohol abuse (OR = 2.95, 95% CI: 1.06-8.23; p = 0.039).
Patients with diabetes, older age, BMI of ≥28 kg/m2 and alcohol abuse or living in rural areas, had increased PJI risk. Additional systematic large-scale studies are needed to verify these results.
本基于医院的病例对照研究旨在评估中国患者全髋关节置换术(THA)和全膝关节置换术(TKA)假体周围关节感染(PJI)的危险因素。
2000年1月至2012年12月,招募了45例接受THA和TKA并发生PJI的患者作为病例组;对照组为252例未发生PJI的患者,根据初次手术年份和手术类型进行匹配。进行条件逻辑回归以计算比值比(OR)和95%置信区间(CI)。
与PJI调整后风险增加相关的人口统计学因素和合并症(按重要性降序排列)为糖尿病(OR = 5.47,95%CI:1.77 - 16.97;p = 0.003)、年龄(65 - 75岁 vs. 45 - 65岁)(OR = 3.36,95%CI:1.30 - 8.69;p = 0.013)、体重指数(BMI)(≥28 vs. 18.5 - 28 kg/m²)(OR = 2.77,95%CI:1.20 - 6.40;p = 0.017)、居住地(农村)(OR = 2.63,95%CI:1.13 - 6.10;p = 0.025)和酗酒(OR = 2.95,95%CI:1.06 - 8.23;p = 0.039)。
患有糖尿病、年龄较大、BMI≥28 kg/m²、酗酒或居住在农村地区的患者,发生PJI的风险增加。需要进一步进行系统的大规模研究来验证这些结果。