Jung Patrick, Morris Arthur J, Zhu Mark, Roberts Sally A, Frampton Chris, Young Simon W
Medical Student, School of Medicine, University of Auckland, Auckland.
Clinical Microbiologist, Auckland City Hospital, Clinical Lead for the Health Quality and Safety Commission's NZ SSIIP.
N Z Med J. 2017 Sep 1;130(1461):24-34.
To identify patient and surgical risk factors that are associated with periprosthetic joint infection (PJI), especially whether obesity is a risk factor following total hip arthroplasty (THA) and total knee arthroplasty (TKA).
New Zealand Surgical Site Infection Improvement Programme data was analysed using deep infection within 90 days of the index procedure as the outcome. This was tested against surgical and patient factors for statistical associations in a multivariate model.
A total of 10,690 primary THAs and 9,481 primary TKAs were recorded by the NZSSIIP between 2013 and 2015. Multivariate analysis showed statistically significant associations with deep infections for BMI (BMI >40kg/m2 OR 5.62, 95% CI 2.25-14.0), male gender (OR 1.7, 95% CI 1.05-2.74) and age greater than 75 for THAs (age <55 years OR 0.35, 95% CI 0.14-0.87). For TKAs, multivariate analysis showed statistically significant associations with deep infection for BMI (BMI >40kg/m2 OR 1.94, 95% CI: 0.63-5.70) and male gender (OR 2.96, 95% CI 1.51-5.80).
These findings show that obesity is one of the most important modifiable patient factors in predicting PJI following THA and TKA.
确定与人工关节周围感染（PJI）相关的患者和手术风险因素，尤其是肥胖是否为全髋关节置换术（THA）和全膝关节置换术（TKA）后的风险因素。
分析新西兰手术部位感染改善计划的数据，将首次手术90天内的深部感染作为结局指标。在多变量模型中针对手术和患者因素进行统计学关联检验。
新西兰手术部位感染改善计划在2013年至2015年期间共记录了10690例初次THA和9481例初次TKA。多变量分析显示，BMI（BMI>40kg/m²，比值比5.62，95%置信区间2.25 - 14.0）、男性（比值比1.7，95%置信区间1.05 - 2.74）以及THA中年龄大于75岁（年龄<55岁，比值比0.35，95%置信区间0.14 - 0.87）与深部感染存在统计学显著关联。对于TKA，多变量分析显示BMI（BMI>40kg/m²，比值比1.94，95%置信区间：0.63 - 5.70）和男性（比值比2.96，95%置信区间1.51 - 5.80）与深部感染存在统计学显著关联。
这些研究结果表明，肥胖是预测THA和TKA后PJI的最重要的可改变患者因素之一。
