Kong Lingde, Cao Junming, Zhang Yingze, Ding Wenyuan, Shen Yong
Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Hebei, P.R. China.
Int Wound J. 2017 Jun;14(3):529-536. doi: 10.1111/iwj.12640. Epub 2016 Jul 10.
To identify risk factors for periprosthetic joint infection following primary total joint arthroplasty, a systematic search was performed in Pubmed, Embase and Cochrane library databases. Pooled odds ratios (ORs) or standardised mean differences (SMDs) with 95% confidence intervals (CIs) were calculated. Patient characteristics, surgical-related factors and comorbidities, as potential risk factors, were investigated. The main factors associated with infection after total joint arthroplasty (TJA) were male gender (OR, 1·48; 95% CI, 1.19-1.85), age (SMD, -0·10; 95% CI, -0.17--0.03), obesity (OR, 1·54; 95% CI, 1·25-1·90), alcohol abuse (OR, 1·88; 95% CI, 1·32-2·68), American Society of Anesthesiologists (ASA) scale > 2 (OR, 2·06; 95% CI, 1·77-2·39), operative time (SMD, 0·49; 95% CI, 0·19-0·78), drain usage (OR, 0·36; 95% CI, 0·18-0·74), diabetes mellitus (OR, 1·58; 95% CI, 1·37-1·81), urinary tract infection (OR, 1·53; 95% CI, 1.09-2.16) and rheumatoid arthritis (OR, 1·57; 95% CI, 1·30-1·88). Among these risk factors, ASA score > 2 was a high risk factor, and drain usage was a protective factor. There was positive evidence for some factors that could be used to prevent the onset of infection after TJA.
为了确定初次全关节置换术后假体周围关节感染的危险因素，我们在PubMed、Embase和Cochrane图书馆数据库中进行了系统检索。计算了合并比值比（OR）或标准化均数差（SMD）以及95%置信区间（CI）。对患者特征、手术相关因素和合并症等潜在危险因素进行了研究。全关节置换术（TJA）后与感染相关的主要因素包括男性（OR，1.48；95%CI，1.19 - 1.85）、年龄（SMD，-0.10；95%CI，-0.17 - -0.03）、肥胖（OR，1.54；95%CI，1.25 - 1.90）、酗酒（OR，1.88；95%CI，1.32 - 2.68）、美国麻醉医师协会（ASA）分级>2（OR，2.06；95%CI，1.77 - 2.39）、手术时间（SMD，0.49；95%CI，0.19 - 0.78）、引流管使用（OR，0.36；95%CI，0.18 - 0.74）、糖尿病（OR，1.58；95%CI，1.37 - 1.81）、尿路感染（OR，1.53；95%CI，1.09 - 2.16）和类风湿关节炎（OR，1.57；95%CI, 1.30 - 1.88）。在这些危险因素中，ASA评分>2是高危因素，引流管使用是保护因素。有一些因素有积极证据可用于预防TJA后感染的发生。
