Poultsides Lazaros A, Triantafyllopoulos Georgios K, Sakellariou Vasileios I, Memtsoudis Stavros G, Sculco Thomas P
Department of Orthopaedic Surgery, Division of Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, Weill Medical College of Cornell University, 535 East 70th Street, New York, NY, 10021, USA.
Department of Anesthesiology, Hospital for Special Surgery, Weill Medical College of Cornell University, 535 East 70th Street, New York, NY, 10021, USA.
Int Orthop. 2018 Jan;42(1):87-94. doi: 10.1007/s00264-017-3675-z. Epub 2017 Nov 12.
To determine the incidence and to identify potential risk factors for in-hospital and late infections, as well as for deep periprosthetic joint infection (PJI) following TKA.
We identified 17,959 patients treated with primary TKA between 2000 and 2009. We recorded patient demographics, comorbidities and in-hospital complications. The rates of in-hospital, late, and deep PJIs were determined. Different logistic regression models were built to identify risk factors for each of the above types of infection.
The rates for in-hospital, post-discharge, and deep PJI were 0.65%, 0.41%, and 0.26%, respectively. Younger age, allogeneic blood transfusion, liver disease, and unilateral or staged bilateral TKA were risk factors for in-hospital infection. Renal and pulmonary disease, urinary tract infection, wound dehiscence, and prior in-hospital infection were risk factors for post-discharge infection. Male gender, history of in-hospital infection, prolonged length of stay, and pulmonary disease were identified as risk factors for deep PJI.
Despite low infection rates after primary TKA, there are patients at higher risk that would benefit by addressing modifiable risk factors for both in-hospital or post-discharge infections, including deep PJIs.
确定全膝关节置换术（TKA）后医院内感染和晚期感染以及深部假体周围关节感染（PJI）的发生率，并识别潜在风险因素。
我们纳入了2000年至2009年间接受初次TKA治疗的17959例患者。我们记录了患者的人口统计学资料、合并症和医院内并发症。确定了医院内感染、晚期感染和深部PJI的发生率。建立了不同的逻辑回归模型以识别上述每种感染类型的风险因素。
医院内感染、出院后感染和深部PJI的发生率分别为0.65%、0.41%和0.26%。年龄较小、异体输血、肝病以及单侧或分期双侧TKA是医院内感染的风险因素。肾脏和肺部疾病、尿路感染、伤口裂开以及既往医院内感染是出院后感染的风险因素。男性、医院内感染史、住院时间延长和肺部疾病被确定为深部PJI的风险因素。
尽管初次TKA后感染率较低，但仍有风险较高的患者，通过针对医院内或出院后感染（包括深部PJI）的可改变风险因素进行处理可能会受益。
