Protective effect of N-acetylcysteine in prosthetic joint infection: A nationwide population-based cohort study
Purpose: This nationwide population-based retrospective cohort study evaluated the protective effect of N-acetylcysteine against prosthetic joint infection after hip or knee joint replacement. Methods: Patients receiving N-acetylcysteine after hip or knee joint replacement between 2000 and 2015 were...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-04-01
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| Series: | Journal of Microbiology, Immunology and Infection |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1684118218302111 |
| _version_ | 1818936310833872896 |
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| author | Chan-Yuan Chang Wu-Chien Chien Chi-Hsiang Chung Chang-Huei Tsao Fu-Huang Lin Feng-Yee Chang Shih-Ta Shang Yung-Chih Wang |
| author_facet | Chan-Yuan Chang Wu-Chien Chien Chi-Hsiang Chung Chang-Huei Tsao Fu-Huang Lin Feng-Yee Chang Shih-Ta Shang Yung-Chih Wang |
| author_sort | Chan-Yuan Chang |
| collection | DOAJ |
| description | Purpose: This nationwide population-based retrospective cohort study evaluated the protective effect of N-acetylcysteine against prosthetic joint infection after hip or knee joint replacement. Methods: Patients receiving N-acetylcysteine after hip or knee joint replacement between 2000 and 2015 were identified from the Taiwan National Health Insurance Research Database. Each patient receiving N-acetylcysteine was matched to four controls based on age, sex, and index year. All subjects were followed-up from the index date to December 31, 2015. The Cox proportional hazards regression model was used to assess the risk of prosthetic joint infection. Results: A total of 1478 patients were included in the study group, and 5912 matched subjects not receiving N-acetylcysteine were included in the control group. After adjusting for age, sex, insured premium, comorbidities, and immunosuppressive agent use, no significant difference in the risk of prosthetic joint infection was found between the two groups. A higher N-acetylcysteine dose (>360 cumulative defined daily dose) significantly decreased the risk of prosthetic joint infection (adjusted hazard ratio = 0.891; 95% confidence interval = 0.599–0.989; p = 0.042). The protective effect of N-acetylcysteine was observed only in the group of prosthetic joint infection within 5 years (adjusted hazard ratio = 0.801; 95% confidence interval = 0.581–0.980; p = 0.040). Conclusions: High cumulative dose of N-acetylcysteine (>360 cumulative defined daily dose) can effectively reduce the risk of prosthetic joint infection in patients undergoing knee or hip joint replacement surgery within 5 years. Keywords: Biofilm, N-acetylcysteine, Prosthetic joint infection |
| first_indexed | 2024-12-20T05:34:02Z |
| format | Article |
| id | doaj.art-c9aa84dca4f34bad9057f64908063b02 |
| institution | Directory Open Access Journal |
| issn | 1684-1182 |
| language | English |
| last_indexed | 2024-12-20T05:34:02Z |
| publishDate | 2020-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Microbiology, Immunology and Infection |
| spelling | doaj.art-c9aa84dca4f34bad9057f64908063b022022-12-21T19:51:40ZengElsevierJournal of Microbiology, Immunology and Infection1684-11822020-04-01532225233Protective effect of N-acetylcysteine in prosthetic joint infection: A nationwide population-based cohort studyChan-Yuan Chang0Wu-Chien Chien1Chi-Hsiang Chung2Chang-Huei Tsao3Fu-Huang Lin4Feng-Yee Chang5Shih-Ta Shang6Yung-Chih Wang7Department of Medicine, Hualien-Armed Forces General Hospital, Hualien County, Taiwan; Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei City, TaiwanSchool of Public Health, National Defense Medical Center, Taipei City, Taiwan; Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei City, TaiwanSchool of Public Health, National Defense Medical Center, Taipei City, Taiwan; Taiwanese Injury Prevention and Safety Promotion Association (TIPSPA), Taipei City, TaiwanDepartment of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei City, TaiwanSchool of Public Health, National Defense Medical Center, Taipei City, TaiwanDivision of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei City, TaiwanDivision of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan; Department of Internal Medicine, Armed Forces Taoyuan General Hospital, Taoyuan City, Taiwan; Corresponding author. Department of Internal Medicine, Armed Forces Taoyuan General Hospital, No. 168, Chong Shin Road, Lungtan District, Taoyuan City, Taiwan.Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan; Corresponding author. Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, No. 325, Sec. 2, Chenggong Road, Neihu District, Taipei City, Taiwan. Fax: +886 2 87927258.Purpose: This nationwide population-based retrospective cohort study evaluated the protective effect of N-acetylcysteine against prosthetic joint infection after hip or knee joint replacement. Methods: Patients receiving N-acetylcysteine after hip or knee joint replacement between 2000 and 2015 were identified from the Taiwan National Health Insurance Research Database. Each patient receiving N-acetylcysteine was matched to four controls based on age, sex, and index year. All subjects were followed-up from the index date to December 31, 2015. The Cox proportional hazards regression model was used to assess the risk of prosthetic joint infection. Results: A total of 1478 patients were included in the study group, and 5912 matched subjects not receiving N-acetylcysteine were included in the control group. After adjusting for age, sex, insured premium, comorbidities, and immunosuppressive agent use, no significant difference in the risk of prosthetic joint infection was found between the two groups. A higher N-acetylcysteine dose (>360 cumulative defined daily dose) significantly decreased the risk of prosthetic joint infection (adjusted hazard ratio = 0.891; 95% confidence interval = 0.599–0.989; p = 0.042). The protective effect of N-acetylcysteine was observed only in the group of prosthetic joint infection within 5 years (adjusted hazard ratio = 0.801; 95% confidence interval = 0.581–0.980; p = 0.040). Conclusions: High cumulative dose of N-acetylcysteine (>360 cumulative defined daily dose) can effectively reduce the risk of prosthetic joint infection in patients undergoing knee or hip joint replacement surgery within 5 years. Keywords: Biofilm, N-acetylcysteine, Prosthetic joint infectionhttp://www.sciencedirect.com/science/article/pii/S1684118218302111 |
| spellingShingle | Chan-Yuan Chang Wu-Chien Chien Chi-Hsiang Chung Chang-Huei Tsao Fu-Huang Lin Feng-Yee Chang Shih-Ta Shang Yung-Chih Wang Protective effect of N-acetylcysteine in prosthetic joint infection: A nationwide population-based cohort study Journal of Microbiology, Immunology and Infection |
| title | Protective effect of N-acetylcysteine in prosthetic joint infection: A nationwide population-based cohort study |
| title_full | Protective effect of N-acetylcysteine in prosthetic joint infection: A nationwide population-based cohort study |
| title_fullStr | Protective effect of N-acetylcysteine in prosthetic joint infection: A nationwide population-based cohort study |
| title_full_unstemmed | Protective effect of N-acetylcysteine in prosthetic joint infection: A nationwide population-based cohort study |
| title_short | Protective effect of N-acetylcysteine in prosthetic joint infection: A nationwide population-based cohort study |
| title_sort | protective effect of n acetylcysteine in prosthetic joint infection a nationwide population based cohort study |
| url | http://www.sciencedirect.com/science/article/pii/S1684118218302111 |
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