Institute of Epidemiology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.
Section of Public Health, Center for Environmental, Department of Biomedical, Metabolic and Neural Sciences, Nutritional and Genetic Epidemiology (CREAGEN), University of Modena and Reggio Emilia, 41121 Modena, Italy.
Int J Environ Res Public Health. 2021 Jan 20;18(3):863. doi: 10.3390/ijerph18030863.
The data about the incidence and risk factors for surgical site infections (SSIs) following total joint arthroplasty (TJA) in middle-income countries are still scant. The aim of this study was to assess the incidence and risk factors associated with 30-day SSIs following total hip arthroplasty (THA) and total knee arthroplasty (TKA). The study was conducted at the Clinic for Orthopedic Surgery and Traumatology, Clinical Center of Serbia (CCS) in Belgrade, from May 2016 to April 2018. All patients undergoing THA or TKA were followed throughout hospitalization until day 30 after discharge. Of the 1073 admitted patients, 459 had THA and 230 had TKA. The incidence rate of surgical site infections (SSIs) among the patients who underwent THA was 5.4%, which is 3.8 per 1000 postoperative patient-days, while the rate among those who had TKA was 4.8%, i.e., 3.4 per 1000 postoperative patient-days. Out of the 36 SSIs, 15 were deep and 21 were superficial incisional ones. Among the variables examined, the independent risk factors for SSIs after THA were the American Society of Anesthesiologists (ASA) score > 2 (RR = 3.17; 95% CI-1.26-8.02), smoking (RR = 3.14; 95% CI-1.26-7.82) and peripheral vascular disease (PVD) (RR = 6.09; 95% CI-2.35-15.77), and after TKA, only PVD (RR = 3.87; 95% CI-1.09-13.76) was the risk factor. Incidence rates of SSIs after arthroplasty are higher compared to reports from developed countries. Therefore, it is necessary to enhance infection prevention and control measures with strict control of modifiable risk factors.
在中等收入国家，关于全关节置换术后手术部位感染（SSI）的发生率和危险因素的数据仍然很少。本研究的目的是评估全髋关节置换术（THA）和全膝关节置换术（TKA）后 30 天内 SSI 的发生率和相关危险因素。该研究在塞尔维亚临床中心骨科和创伤科诊所（CCS）进行，时间为 2016 年 5 月至 2018 年 4 月。所有接受 THA 或 TKA 的患者在住院期间一直随访至出院后第 30 天。在 1073 名入院患者中，459 例接受 THA，230 例接受 TKA。接受 THA 的患者中手术部位感染（SSI）的发生率为 5.4%，即每 1000 个术后患者日 3.8 例，而接受 TKA 的患者中发生率为 4.8%，即每 1000 个术后患者日 3.4 例。在 36 例 SSI 中，15 例为深部感染，21 例为浅部切口感染。在检查的变量中，THA 后 SSI 的独立危险因素是美国麻醉医师协会（ASA）评分>2（RR=3.17；95%CI-1.26-8.02）、吸烟（RR=3.14；95%CI-1.26-7.82）和外周血管疾病（PVD）（RR=6.09；95%CI-2.35-15.77），而在 TKA 后，只有 PVD（RR=3.87；95%CI-1.09-13.76）是危险因素。与发达国家的报告相比，关节置换术后 SSI 的发生率更高。因此，有必要加强感染预防和控制措施，严格控制可改变的危险因素。
