Somerson Jeremy S, Boylan Matthew R, Hug Kevin T, Naziri Qais, Paulino Carl B, Huang Jerry I
University of Texas Medical Branch, Galveston, TX, USA.
NYU Hospital for Joint Diseases, New York, NY, USA.
Shoulder Elbow. 2019 Apr;11(2):116-120. doi: 10.1177/1758573217741318. Epub 2017 Nov 8.
For patients undergoing total elbow arthroplasty (TEA), the present study aimed to investigate: (i) what risk factors are associated with periprosthetic elbow infection; (ii) what is the incidence of infection after TEA; and (iii) what is the acuity with which these infections present?
The Statewide Planning and Research Cooperative System database was used to identify all patients who underwent TEA between 2003 and 2012 in New York State. Admissions for prosthetic joint infection (PJI) were identified using ICD-9 (International Classification of Diseases, Ninth Revision, Clinical Modification) diagnosis code 996.66. Multivariate analysis was used to determine risk factors that were independently prognostic for PJI.
Significant risk factors for PJI included hypothyroidism [odds ratio (OR) = 2.04; = 0.045], tobacco use disorder (OR = 3.39; = 0.003) and rheumatoid arthritis (OR = 3.31; < 0.001). Among the 1452 patients in the study period who underwent TEA, 3.7% ( = 54) were admitted postoperatively for PJI. There were 30 (56%) early infections, 17 (31%) delayed infections and seven (13%) late infections.
Pre-operative optimization of thyroid function, smoking cessation and management of rheumatoid disease may be considered in surgical candidates for TEA. The results of the present study add prognostic data to the literature that may be helpful with patient selection and risk profile analysis.
Level III: prognostic study.
对于接受全肘关节置换术（TEA）的患者，本研究旨在调查：（i）哪些危险因素与假体周围肘关节感染相关；（ii）TEA术后感染的发生率是多少；以及（iii）这些感染出现的严重程度如何？
利用全州规划与研究合作系统数据库，确定2003年至2012年在纽约州接受TEA的所有患者。使用国际疾病分类第九版临床修订本（ICD-9）诊断代码996.66来识别假体关节感染（PJI）的入院病例。采用多变量分析来确定对PJI具有独立预后意义的危险因素。
PJI的显著危险因素包括甲状腺功能减退[比值比（OR）=2.04；P=0.045]、烟草使用障碍（OR=3.39；P=0.003）和类风湿性关节炎（OR=3.31；P<0.001）。在研究期间接受TEA的1452例患者中，3.7%（n=54）术后因PJI入院。有30例（56%）为早期感染，17例（31%）为延迟感染，7例（13%）为晚期感染。
对于TEA手术候选人，可考虑术前优化甲状腺功能、戒烟和控制类风湿疾病。本研究结果为文献增添了预后数据，可能有助于患者选择和风险评估分析。
III级：预后研究。
