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急性与慢性人工关节感染的早期结局差异——一项回顾性单中心研究

Early-Outcome Differences between Acute and Chronic Periprosthetic Joint Infections-A Retrospective Single-Center Study.

作者信息

Youssef Yasmin, Roschke Elisabeth, Dietze Nadine, Dahse Anna-Judith, Chaberny Iris F, Ranft Donald, Pempe Christina, Goralski Szymon, Ghanem Mohamed, Kluge Regine, Lübbert Christoph, Rodloff Arne C, Roth Andreas

机构信息

Department of Orthopedics, Traumatology and Plastic Surgery, University Hospital Leipzig, Liebigstraße 20, 04103 Leipzig, Germany.

Institute of Medical Microbiology and Virology, University Hospital Leipzig, Liebigstraße 21, 04103 Leipzig, Germany.

出版信息

Antibiotics (Basel). 2024 Feb 20;13(3):198. doi: 10.3390/antibiotics13030198.

Abstract

Periprosthetic joint infections (PJI) are serious complications after arthroplasty, associated with high morbidity, mortality, and complex treatment processes. The outcomes of different PJI entities are largely unknown. The aim of this study was to access the early outcomes of different PJI entities. A retrospective, single-center study was conducted. The characteristics and outcomes of patients with PJI treated between 2018 and 2019 were evaluated 12 months after the completion of treatment. Primary endpoints were mortality, relapse free survival (RFS) and postoperative complications (kidney failure, sepsis, admission to ICU). A total of 115 cases were included [19.1% early (EI), 33.0% acute late (ALI), and 47.8% chronic infections (CI)]. Patients with ALI were older ( = 0.023), had higher ASA scores ( = 0.031), preoperative CRP concentrations ( = 0.011), incidence of kidney failure ( = 0.002) and sepsis ( = 0.026). They also tended towards higher in-house mortality (ALI 21.1%, 13.6% EI, 5.5% CI) and admission to ICU (ALI 50.0%, 22.7% EI, 30.9% CI). At 12 months, 15.4% of patients with EI had a relapse, compared to 38.1% in ALI and 36.4% in CI. There are differences in patient characteristics and early outcomes between PJI entities. Patients with EI have better early clinical outcomes. Patients with ALI require special attention during follow-up because they have higher occurrences of relapses and postoperative complications than patients with EI and CI.

摘要

人工关节周围感染(PJI)是关节置换术后的严重并发症,具有高发病率、高死亡率以及复杂的治疗过程。不同类型PJI的治疗结果在很大程度上尚不清楚。本研究的目的是评估不同类型PJI的早期治疗结果。进行了一项回顾性单中心研究。对2018年至2019年期间接受治疗的PJI患者的特征和治疗结果在治疗结束12个月后进行了评估。主要终点为死亡率、无复发生存期(RFS)和术后并发症(肾衰竭、脓毒症、入住重症监护病房)。共纳入115例病例[早期感染(EI)占19.1%,急性晚期感染(ALI)占33.0%,慢性感染(CI)占47.8%]。ALI患者年龄更大(P = 0.023),美国麻醉医师协会(ASA)评分更高(P = 0.031),术前C反应蛋白(CRP)浓度更高(P = 0.011),肾衰竭发生率(P = 0.002)和脓毒症发生率(P = 0.026)更高。他们的院内死亡率(ALI为21.1%,EI为13.6%,CI为5.5%)和入住重症监护病房的比例(ALI为50.0%,EI为22.7%,CI为30.9%)也往往更高。在12个月时,EI患者的复发率为15.4%,而ALI患者为38.1%,CI患者为36.4%。不同类型PJI在患者特征和早期治疗结果方面存在差异。EI患者具有更好的早期临床结果。ALI患者在随访期间需要特别关注,因为他们比EI和CI患者有更高的复发率和术后并发症发生率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8944/10967401/e0a95d1644cc/antibiotics-13-00198-g001.jpg

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