Variation in Prosthetic Joint Infection and treatment strategies during 4.5 years of follow-up after primary joint arthroplasty using administrative data of 41397 patients across Australian, European and United States hospitals
Abstract Background To identify best practices and quality improvement initiatives, we aimed to assess whether the incidence of Periprosthetic Joint Infection (PJI) and treatment strategies differed across patients treated in Australian, European and United States (US) hospitals. Methods Routinely c...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2017-05-01
|
| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12891-017-1569-2 |
| _version_ | 1830297643590352896 |
|---|---|
| author | Perla J. Marang-van de Mheen Ellie Bragan Turner Susan Liew Nora Mutalima Ton Tran Sten Rasmussen Rob G. H. H. Nelissen Andrew Gordon |
| author_facet | Perla J. Marang-van de Mheen Ellie Bragan Turner Susan Liew Nora Mutalima Ton Tran Sten Rasmussen Rob G. H. H. Nelissen Andrew Gordon |
| author_sort | Perla J. Marang-van de Mheen |
| collection | DOAJ |
| description | Abstract Background To identify best practices and quality improvement initiatives, we aimed to assess whether the incidence of Periprosthetic Joint Infection (PJI) and treatment strategies differed across patients treated in Australian, European and United States (US) hospitals. Methods Routinely collected administrative data for 41397 patients undergoing a primary total hip or knee arthroplasty between July 2007-December 2010 across 22 hospitals were included. Patients were followed for 2 years looking for PJI occurrence, defined as early (within 4 weeks) and late PJI, and surgical treatment during 2.5 years after PJI diagnosis. Logistic and Poisson regression models were used to test for differences in PJI occurrence and treatment strategies across the three geographical regions, adjusted for age, sex, joint and Elixhauser comorbidity groups. Results PJI occurrence varied from 1.4% in European to 1.7% in Australian patients, which were significantly higher than US patients after adjustment for patient characteristics (OR 1.24 [1.01–1.52] and 1.40 [1.03–1.91] respectively). Early PJIs varied between 0.3% in European to 0.6% in Australian patients, but adjusted rates were similar. Revision following PJI was significantly lower in Australian than in US patients (OR 0.46 [0.25–0.86]) as were the total number of revisions (RR 0.51 [0.36–0.71]) and number of surgical procedures (RR 0.60 [0.44–0.81]) used to treat PJI. Conclusion The overall PJI rate was significantly higher in Australian patients, but fewer procedures were needed to treat these PJIs. Future research should reveal whether this reflects PJIs caught earlier or less severe when diagnosed, and whether this is associated with the longer length of stay after primary arthroplasty in Australian hospitals. |
| first_indexed | 2024-12-19T07:38:24Z |
| format | Article |
| id | doaj.art-772e21f275774622966bbfd24e87a0f5 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-19T07:38:24Z |
| publishDate | 2017-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-772e21f275774622966bbfd24e87a0f52022-12-21T20:30:32ZengBMCBMC Musculoskeletal Disorders1471-24742017-05-011811810.1186/s12891-017-1569-2Variation in Prosthetic Joint Infection and treatment strategies during 4.5 years of follow-up after primary joint arthroplasty using administrative data of 41397 patients across Australian, European and United States hospitalsPerla J. Marang-van de Mheen0Ellie Bragan Turner1Susan Liew2Nora Mutalima3Ton Tran4Sten Rasmussen5Rob G. H. H. Nelissen6Andrew Gordon7Department of Medical Decision Making, Leiden University Medical CenterDr Foster LtdDepartment of Orthopaedic Surgery, Alfred HospitalDepartment of Orthopaedic Surgery, Monash HealthDepartment of Orthopaedic Surgery, Monash HealthOrthopaedic Surgery Research Unit, Aalborg University HospitalDepartment of Orthopaedic Surgery, Leiden University Medical CenterDepartment of Orthopaedic Surgery, Sheffield Teaching Hospitals NHS trustAbstract Background To identify best practices and quality improvement initiatives, we aimed to assess whether the incidence of Periprosthetic Joint Infection (PJI) and treatment strategies differed across patients treated in Australian, European and United States (US) hospitals. Methods Routinely collected administrative data for 41397 patients undergoing a primary total hip or knee arthroplasty between July 2007-December 2010 across 22 hospitals were included. Patients were followed for 2 years looking for PJI occurrence, defined as early (within 4 weeks) and late PJI, and surgical treatment during 2.5 years after PJI diagnosis. Logistic and Poisson regression models were used to test for differences in PJI occurrence and treatment strategies across the three geographical regions, adjusted for age, sex, joint and Elixhauser comorbidity groups. Results PJI occurrence varied from 1.4% in European to 1.7% in Australian patients, which were significantly higher than US patients after adjustment for patient characteristics (OR 1.24 [1.01–1.52] and 1.40 [1.03–1.91] respectively). Early PJIs varied between 0.3% in European to 0.6% in Australian patients, but adjusted rates were similar. Revision following PJI was significantly lower in Australian than in US patients (OR 0.46 [0.25–0.86]) as were the total number of revisions (RR 0.51 [0.36–0.71]) and number of surgical procedures (RR 0.60 [0.44–0.81]) used to treat PJI. Conclusion The overall PJI rate was significantly higher in Australian patients, but fewer procedures were needed to treat these PJIs. Future research should reveal whether this reflects PJIs caught earlier or less severe when diagnosed, and whether this is associated with the longer length of stay after primary arthroplasty in Australian hospitals.http://link.springer.com/article/10.1186/s12891-017-1569-2Periprosthetic Joint InfectionInternational variationTotal joint replacementTreatment strategies |
| spellingShingle | Perla J. Marang-van de Mheen Ellie Bragan Turner Susan Liew Nora Mutalima Ton Tran Sten Rasmussen Rob G. H. H. Nelissen Andrew Gordon Variation in Prosthetic Joint Infection and treatment strategies during 4.5 years of follow-up after primary joint arthroplasty using administrative data of 41397 patients across Australian, European and United States hospitals BMC Musculoskeletal Disorders Periprosthetic Joint Infection International variation Total joint replacement Treatment strategies |
| title | Variation in Prosthetic Joint Infection and treatment strategies during 4.5 years of follow-up after primary joint arthroplasty using administrative data of 41397 patients across Australian, European and United States hospitals |
| title_full | Variation in Prosthetic Joint Infection and treatment strategies during 4.5 years of follow-up after primary joint arthroplasty using administrative data of 41397 patients across Australian, European and United States hospitals |
| title_fullStr | Variation in Prosthetic Joint Infection and treatment strategies during 4.5 years of follow-up after primary joint arthroplasty using administrative data of 41397 patients across Australian, European and United States hospitals |
| title_full_unstemmed | Variation in Prosthetic Joint Infection and treatment strategies during 4.5 years of follow-up after primary joint arthroplasty using administrative data of 41397 patients across Australian, European and United States hospitals |
| title_short | Variation in Prosthetic Joint Infection and treatment strategies during 4.5 years of follow-up after primary joint arthroplasty using administrative data of 41397 patients across Australian, European and United States hospitals |
| title_sort | variation in prosthetic joint infection and treatment strategies during 4 5 years of follow up after primary joint arthroplasty using administrative data of 41397 patients across australian european and united states hospitals |
| topic | Periprosthetic Joint Infection International variation Total joint replacement Treatment strategies |
| url | http://link.springer.com/article/10.1186/s12891-017-1569-2 |
| work_keys_str_mv | AT perlajmarangvandemheen variationinprostheticjointinfectionandtreatmentstrategiesduring45yearsoffollowupafterprimaryjointarthroplastyusingadministrativedataof41397patientsacrossaustralianeuropeanandunitedstateshospitals AT elliebraganturner variationinprostheticjointinfectionandtreatmentstrategiesduring45yearsoffollowupafterprimaryjointarthroplastyusingadministrativedataof41397patientsacrossaustralianeuropeanandunitedstateshospitals AT susanliew variationinprostheticjointinfectionandtreatmentstrategiesduring45yearsoffollowupafterprimaryjointarthroplastyusingadministrativedataof41397patientsacrossaustralianeuropeanandunitedstateshospitals AT noramutalima variationinprostheticjointinfectionandtreatmentstrategiesduring45yearsoffollowupafterprimaryjointarthroplastyusingadministrativedataof41397patientsacrossaustralianeuropeanandunitedstateshospitals AT tontran variationinprostheticjointinfectionandtreatmentstrategiesduring45yearsoffollowupafterprimaryjointarthroplastyusingadministrativedataof41397patientsacrossaustralianeuropeanandunitedstateshospitals AT stenrasmussen variationinprostheticjointinfectionandtreatmentstrategiesduring45yearsoffollowupafterprimaryjointarthroplastyusingadministrativedataof41397patientsacrossaustralianeuropeanandunitedstateshospitals AT robghhnelissen variationinprostheticjointinfectionandtreatmentstrategiesduring45yearsoffollowupafterprimaryjointarthroplastyusingadministrativedataof41397patientsacrossaustralianeuropeanandunitedstateshospitals AT andrewgordon variationinprostheticjointinfectionandtreatmentstrategiesduring45yearsoffollowupafterprimaryjointarthroplastyusingadministrativedataof41397patientsacrossaustralianeuropeanandunitedstateshospitals |