Viola Dan Carai Maia, Rodrigues Neto Henrique Ribeiro, Garcia Jairo Greco, Petrilli Marcelo de Toledo, Carlesse Fabianne Altruda de Moraes Costa, Jesus-Garcia Filho Reynaldo
Instituto de Oncologia Pediátrica (IOP/GRAACC), Departamento de Ortopedia e Traumatologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brasil.
Programa de Ortopedia, Hospital Israelita Albert Einstein, São Paulo, SP, Brasil.
Rev Bras Ortop (Sao Paulo). 2021 Oct 28;56(5):615-620. doi: 10.1055/s-0041-1731354. eCollection 2021 Oct.
To identify the main risk factors related to poor outcomes after the treatment for periprosthetic infection. Medical records from 109 patients who underwent non-conventional endoprosthesis surgeries (primary and revision procedures) from January 1, 2007, to December 31, 2018, were retrospectively evaluated. In total, 15 patients diagnosed with periprosthetic infection were eligible to participate in the study. Variables including gender, age at diagnosis, affected bone, surgery duration, white blood cell (WBC) count before endoprosthesis placement, urinary tract infection during the first postoperative year, and time elapsed from endoprosthesis placement to infection diagnosis were related to outcomes using the Fisher exact test (for the bicategorical variables) or analysis of variance (ANOVA, for the tricategorical variables). The mean times from diagnosis to final outcome were compared using the Student -test. These risk factors did not show a statistically significant correlation with the outcomes. The data revealed a trend towards a difference between the mean time for the onset of infection and the final outcome. Due to the limited sample, we believe that studies with larger cohorts can prove this trend. We identified that the time from endoprosthesis placement to the onset of the symptoms of infection tends to be related to the outcome and evolution of the patient evolution during the treatment for periprosthetic infection. Although apparently correlated, other associated factors were not statistically linked to poor treatment outcomes.
确定与假体周围感染治疗后预后不良相关的主要危险因素。对2007年1月1日至2018年12月31日期间接受非常规假体手术（初次和翻修手术）的109例患者的病历进行回顾性评估。共有15例被诊断为假体周围感染的患者符合参与本研究的条件。使用Fisher精确检验（用于二分类变量）或方差分析（ANOVA，用于三分类变量）分析性别、诊断时年龄、受累骨骼、手术时长、假体植入前白细胞（WBC）计数、术后第一年的尿路感染以及从假体植入到感染诊断的时间等变量与预后的关系。使用Student检验比较从诊断到最终结局的平均时间。
这些危险因素与预后未显示出统计学上的显著相关性。数据显示感染发作的平均时间与最终结局之间存在差异趋势。由于样本量有限，我们认为更大队列的研究可以证实这一趋势。
我们发现，从假体植入到感染症状出现的时间往往与假体周围感染治疗期间患者病情的结局和演变相关。尽管其他相关因素显然相关，但在统计学上与治疗效果不佳并无关联。
