Risk factors for prosthetic joint infections following total hip arthroplasty based on 33,337 hips in the Finnish Arthroplasty Register from 2014 to 2018
Background and purpose — Periprosthetic joint infection (PJI) is a devastating complication and more information on risk factors for PJI is required to find measures to prevent infections. Therefore, we assessed risk factors for PJI after primary total hip arthroplasty (THA) in a large patient cohor...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Medical Journals Sweden
2021-10-01
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| Series: | Acta Orthopaedica |
| Online Access: | http://dx.doi.org/10.1080/17453674.2021.1944529 |
| _version_ | 1819125625743474688 |
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| author | Valtteri J Panula Kasperi J Alakylä Mikko S Venäläinen Jaason J Haapakoski Antti P Eskelinen Mikko J Manninen Jukka S Kettunen Ari-Pekka Puhto Anna I Vasara Laura L Elo Keijo T Mäkelä |
| author_facet | Valtteri J Panula Kasperi J Alakylä Mikko S Venäläinen Jaason J Haapakoski Antti P Eskelinen Mikko J Manninen Jukka S Kettunen Ari-Pekka Puhto Anna I Vasara Laura L Elo Keijo T Mäkelä |
| author_sort | Valtteri J Panula |
| collection | DOAJ |
| description | Background and purpose — Periprosthetic joint infection (PJI) is a devastating complication and more information on risk factors for PJI is required to find measures to prevent infections. Therefore, we assessed risk factors for PJI after primary total hip arthroplasty (THA) in a large patient cohort. Patients and methods — We analyzed 33,337 primary THAs performed between May 2014 and January 2018 based on the Finnish Arthroplasty Register (FAR). Cox proportional hazards regression was used to estimate hazard ratios with 95% confidence intervals (CI) for first PJI revision operation using 25 potential patient- and surgical-related risk factors as covariates. Results — 350 primary THAs were revised for the first time due to PJI during the study period. The hazard ratios for PJI revision in multivariable analysis were 2.0 (CI 1.3–3.2) for ASA class II and 3.2 (2.0–5.1) for ASA class III–IV compared with ASA class I, 1.4 (1.1–1.7) for bleeding > 500 mL compared with < 500 mL, 0.4 (0.2–0.7) for ceramic-on-ceramic bearing couple compared with metal-on-polyethylene and for the first 3 postoperative weeks, 3.0 (1.6–5.6) for operation time of > 120 minutes compared with 45–59 minutes, and 2.6 (1.4–4.9) for simultaneous bilateral operation. In the univariable analysis, hazard ratios for PJI revision were 2.3 (1.7–3.3) for BMI of 31–35 and 5.0 (3.5–7.1) for BMI of > 35 compared with patients with BMI of 21–25. Interpretation — We found several modifiable risk factors associated with increased PJI revision risk after THA to which special attention should be paid preoperatively. In particular, high BMI may be an even more prominent risk factor for PJI than previously assessed. |
| first_indexed | 2024-12-22T07:43:07Z |
| format | Article |
| id | doaj.art-dc1ea6492e58403ab8393fbda594a9f7 |
| institution | Directory Open Access Journal |
| issn | 1745-3674 1745-3682 |
| language | English |
| last_indexed | 2024-12-22T07:43:07Z |
| publishDate | 2021-10-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Acta Orthopaedica |
| spelling | doaj.art-dc1ea6492e58403ab8393fbda594a9f72022-12-21T18:33:42ZengMedical Journals SwedenActa Orthopaedica1745-36741745-36822021-10-0192666567210.1080/17453674.2021.19445291944529Risk factors for prosthetic joint infections following total hip arthroplasty based on 33,337 hips in the Finnish Arthroplasty Register from 2014 to 2018Valtteri J Panula0Kasperi J Alakylä1Mikko S Venäläinen2Jaason J Haapakoski3Antti P Eskelinen4Mikko J Manninen5Jukka S Kettunen6Ari-Pekka Puhto7Anna I Vasara8Laura L Elo9Keijo T Mäkelä10Department of Orthopaedics and Traumatology, Turku University Hospital, and University of TurkuDepartment of Orthopaedics and Traumatology, Turku University Hospital, and University of TurkuTurku Bioscience Centre, University of Turku and Åbo Akademi UniversityNational Institute for Health and WelfareCoxa Hospital for Joint ReplacementOrton HospitalDepartment of Orthopaedics and Traumatology, Kuopio University HospitalDivision of Operative Care, Department of Orthopaedic and Trauma Surgery, Oulu University HospitalHelsinki University HospitalTurku Bioscience Centre, University of Turku and Åbo Akademi UniversityDepartment of Orthopaedics and Traumatology, Turku University Hospital, and University of TurkuBackground and purpose — Periprosthetic joint infection (PJI) is a devastating complication and more information on risk factors for PJI is required to find measures to prevent infections. Therefore, we assessed risk factors for PJI after primary total hip arthroplasty (THA) in a large patient cohort. Patients and methods — We analyzed 33,337 primary THAs performed between May 2014 and January 2018 based on the Finnish Arthroplasty Register (FAR). Cox proportional hazards regression was used to estimate hazard ratios with 95% confidence intervals (CI) for first PJI revision operation using 25 potential patient- and surgical-related risk factors as covariates. Results — 350 primary THAs were revised for the first time due to PJI during the study period. The hazard ratios for PJI revision in multivariable analysis were 2.0 (CI 1.3–3.2) for ASA class II and 3.2 (2.0–5.1) for ASA class III–IV compared with ASA class I, 1.4 (1.1–1.7) for bleeding > 500 mL compared with < 500 mL, 0.4 (0.2–0.7) for ceramic-on-ceramic bearing couple compared with metal-on-polyethylene and for the first 3 postoperative weeks, 3.0 (1.6–5.6) for operation time of > 120 minutes compared with 45–59 minutes, and 2.6 (1.4–4.9) for simultaneous bilateral operation. In the univariable analysis, hazard ratios for PJI revision were 2.3 (1.7–3.3) for BMI of 31–35 and 5.0 (3.5–7.1) for BMI of > 35 compared with patients with BMI of 21–25. Interpretation — We found several modifiable risk factors associated with increased PJI revision risk after THA to which special attention should be paid preoperatively. In particular, high BMI may be an even more prominent risk factor for PJI than previously assessed.http://dx.doi.org/10.1080/17453674.2021.1944529 |
| spellingShingle | Valtteri J Panula Kasperi J Alakylä Mikko S Venäläinen Jaason J Haapakoski Antti P Eskelinen Mikko J Manninen Jukka S Kettunen Ari-Pekka Puhto Anna I Vasara Laura L Elo Keijo T Mäkelä Risk factors for prosthetic joint infections following total hip arthroplasty based on 33,337 hips in the Finnish Arthroplasty Register from 2014 to 2018 Acta Orthopaedica |
| title | Risk factors for prosthetic joint infections following total hip arthroplasty based on 33,337 hips in the Finnish Arthroplasty Register from 2014 to 2018 |
| title_full | Risk factors for prosthetic joint infections following total hip arthroplasty based on 33,337 hips in the Finnish Arthroplasty Register from 2014 to 2018 |
| title_fullStr | Risk factors for prosthetic joint infections following total hip arthroplasty based on 33,337 hips in the Finnish Arthroplasty Register from 2014 to 2018 |
| title_full_unstemmed | Risk factors for prosthetic joint infections following total hip arthroplasty based on 33,337 hips in the Finnish Arthroplasty Register from 2014 to 2018 |
| title_short | Risk factors for prosthetic joint infections following total hip arthroplasty based on 33,337 hips in the Finnish Arthroplasty Register from 2014 to 2018 |
| title_sort | risk factors for prosthetic joint infections following total hip arthroplasty based on 33 337 hips in the finnish arthroplasty register from 2014 to 2018 |
| url | http://dx.doi.org/10.1080/17453674.2021.1944529 |
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