Department of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, Czysta 18 St., 31-121, Kraków, Poland.
Doctoral School of Medical and Health Sciences, Jagiellonian University Medical College, Łazarza 16 St., 31-530, Kraków, Poland.
Sci Rep. 2023 Sep 24;13(1):15940. doi: 10.1038/s41598-023-43111-z.
Arthroplasty is a common procedure improving functioning of patients and their quality of life. Infection is a serious complication that determines subsequent management of the prosthesis and the patient. The aim of the study was to investigate the incidence of post-discharge surgical site infections (SSI) and their risk factors. A retrospective analysis of an anonymized database from the National Health Found for 2017 of 56,068 adult patients undergoing hip replacement surgery (HPRO) and 27,457 patients undergoing knee replacement surgery (KPRO). The cumulative incidence of post-discharge SSI was 0.92% for HPRO and 0.95% for KPRO. The main risk factors for hip SSI were male gender, diseases of hematopoietic, musculoskeletal and nervous system. The risk factor for knee SSI was male gender. All comorbidities significantly increased the risk of SSI. The ICU stay and antibiotics administered at discharge in studied population increased the risk of detection of SSI after HPRO and KPRO by up to four and seven times, respectively. For both procedures rehabilitation after surgery and total endoprosthesis decreased incidence of SSIs. The lower experience of the center was related to higher SSI incidence in HPRO in primary (1.5% vs. 0.9%) and in revision surgeries (3.8% vs. 2.1%), but in KPRO, lower experience only in primary surgeries was significantly associated with SSI. The cumulative incidence of post-discharge SSI in Poland is higher than in other European countries. Special attention should be paid to patients with chronic diseases.
关节置换术是一种常见的手术，可改善患者的功能和生活质量。感染是一种严重的并发症，决定了假体和患者的后续处理。本研究旨在调查出院后手术部位感染（SSI）的发生率及其危险因素。对 2017 年国家卫生基金会 56068 例髋关节置换术（HPRO）和 27457 例膝关节置换术（KPRO）患者匿名数据库进行回顾性分析。HPRO 出院后 SSI 的累积发生率为 0.92%，KPRO 为 0.95%。髋关节 SSI 的主要危险因素为男性、血液、肌肉骨骼和神经系统疾病。膝关节 SSI 的危险因素为男性。所有合并症均显著增加了 SSI 的风险。在研究人群中，入住 ICU 和出院时使用抗生素分别使 HPRO 和 KPRO 术后 SSI 的检出风险增加了 4 倍和 7 倍。两种手术方式中，术后康复和全关节假体都降低了 SSI 的发生率。中心经验较少与 HPRO 初次（1.5%比 0.9%）和翻修手术（3.8%比 2.1%）中 SSI 发生率较高相关，但在 KPRO 中，仅初次手术经验较少与 SSI 显著相关。波兰出院后 SSI 的累积发生率高于其他欧洲国家。应特别关注患有慢性疾病的患者。
