Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina.
Division of Infectious Disease, Department of Medicine, Duke University School of Medicine, North Carolina.
Infect Control Hosp Epidemiol. 2022 Dec;43(12):1853-1858. doi: 10.1017/ice.2022.22. Epub 2022 Mar 7.
Research on complications with peripherally inserted central catheter (PICC) lines that are placed for the treatment of prosthetic joint infection (PJI) after total hip arthroplasty (THA) and total knee arthroplasty (TKA) is scarce. We investigated the timing, frequency, and risk factors for PICC complications during treatment of PJI after THA and TKA.
We retrospectively queried an institutional database for THA and TKA patients from January 2015 through December 2020 that developed a PJI and required PICC placement at an academic, tertiary-care referral center.
The study included 889 patients (48.3% female) with a mean age of 64.6 years (range, 18.7-95.2) who underwent 435 THAs and 454 TKAs that were revised for PJI. The cohort had 275 90-day ED visits (30.9%), and 51 (18.5%) were PICC related. The average time from discharge to PICC ED visit was 26.2 days (range, 0.3-89.4). The most common reasons for a 90-day ED visit were issues related to the joint replacement or wound site (musculoskeletal or MSK; n = 116, 42.2%) and PICC complaints (n = 51, 18.5%). A multivariable logistic regression demonstrated that non-White race (odds ratio [OR], 2.24; 95% confidence interval [CI], 1.24-4.04; = .007) and younger age (OR, 0.98; 95% CI, 0.95-1.00; = .035) were associated with PICC-related ED visits. Malposition/readjustment (41.2%) and occlusion (35.3%) were the most common PICC complications leading to ED presentation.
PICC complications are common after PJI treatment, accounting for nearly 20% of 90-day ED visits.
研究全髋关节置换术（THA）和全膝关节置换术（TKA）后治疗人工关节感染（PJI）时，经外周静脉置入中心静脉导管（PICC）的并发症的发生时间、频率和危险因素。
我们回顾性分析了 2015 年 1 月至 2020 年 12 月在学术性三级转诊中心因 PJI 接受治疗且需要 PICC 置管的 THA 和 TKA 患者的机构数据库。
该研究纳入了 889 名患者（48.3%为女性），平均年龄为 64.6 岁（范围 18.7-95.2 岁），其中 435 例行 THA，454 例行 TKA 翻修治疗 PJI。该队列中有 275 例患者在 90 天内就诊于急诊科（ED），其中 51 例与 PICC 相关。从出院到 PICC ED 就诊的平均时间为 26.2 天（范围 0.3-89.4 天）。90 天内 ED 就诊的最常见原因是与关节置换或伤口部位相关的问题（肌肉骨骼或 MSK；n=116，42.2%）和 PICC 相关的投诉（n=51，18.5%）。多变量逻辑回归显示，非白种人（比值比[OR]，2.24；95%置信区间[CI]，1.24-4.04； =.007）和年龄较小（OR，0.98；95%CI，0.95-1.00； =.035）与 PICC 相关的 ED 就诊相关。位置不当/调整（41.2%）和闭塞（35.3%）是导致 ED 就诊最常见的 PICC 并发症。
在治疗 PJI 后，PICC 并发症很常见，占 90 天内 ED 就诊的近 20%。
