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金黄色葡萄球菌与膝关节化脓性关节炎再次手术的更大需求相关。

S. AUREUS IS ASSOCIATED WITH A GREATER NEED FOR REOPERATION IN SEPTIC ARTHRITIS OF THE KNEE.

作者信息

Fernandes Lucas Saade, Yagi Alexandre Joji, Santos Netto Alfredo Dos, Salles Mauro José, Oliveira Victor Marques DE, Cury Ricardo DE Paula Leite

机构信息

Santa Casa de Misericórdia de Sao Paulo, Faculdade de Ciências Médicas, Departamento de Ortopedia e Traumatologia, Sao Paulo, SP, Brazil.

Santa Casa de Misericórdia de Sao Paulo, Departamento de Ortopedia e Traumatologia, Grupo de Joelho, Sao Paulo, SP, Brazil.

出版信息

Acta Ortop Bras. 2023 May 1;31(2):e260592. doi: 10.1590/1413-785220233102e260592. eCollection 2023.

Abstract

OBJECTIVE

To determine the frequency of reoperations in the treatment of adult patients diagnosed with septic arthritis of the knee, the average number of debridements needed to control the infection, the mortality rate, and to assess factors associated with a greater need for reoperation and mortality.

METHODS

Retrospective cohort study evaluating 38 adult patients diagnosed with septic arthritis who underwent arthrotomy via a medial parapatellar approach for joint cleaning and debridement. Demographic, clinical, surgical, and microbiological variables of the cases were analyzed by review of medical records. Tests for equality of two proportions, chi-square, and multivariate logistic regression analysis were performed, defining a significance level at 0.05, with 95% confidence interval.

RESULTS

A total of 50% of the cases underwent reoperation, with an average number of required debridement of 2.02 and a mortality rate of 10.5%. Patients with infection caused by Staphylococcus aureus were more likely to need a reoperation compared to patients with positive cultures for other agents (OR 6.0).

CONCLUSION

In 50% of cases, an average of 2.02 debridements were necessary and the mortality rate was 10.5%. Staphylococcus aureus infection is associated with a 6 times greater chance of additional surgeries. /

摘要

目的

确定诊断为成人膝关节化脓性关节炎的患者再次手术的频率、控制感染所需的平均清创次数、死亡率,并评估与再次手术和死亡需求增加相关的因素。

方法

回顾性队列研究,评估38例诊断为化脓性关节炎的成年患者,这些患者通过髌旁内侧入路进行关节切开术以进行关节清理和清创。通过查阅病历分析病例的人口统计学、临床、手术和微生物学变量。进行两比例相等性检验、卡方检验和多因素逻辑回归分析,定义显著性水平为0.05,置信区间为95%。

结果

共有50%的病例接受了再次手术,所需清创的平均次数为2.02次,死亡率为10.5%。与其他病原体培养阳性的患者相比,金黄色葡萄球菌感染的患者更有可能需要再次手术(比值比6.0)。

结论

50%的病例平均需要2.02次清创,死亡率为10.5%。金黄色葡萄球菌感染与再次手术的可能性增加6倍相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8eba/10158961/a043dbe314ec/1809-4406-aob-31-02-e260592-gf1.jpg

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