Prevalence of modifiable risk factors in primary elective arthroplasty and their association with infections
Background and purpose: The aim of this study was to identify the prevalence of modifiable risk factors of surgical site infections (SSI) in patients undergoing primary elective total joint arthroplasty (TJA) receiving conventional preoperative preparation, and to explore their association with inf...
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| Format: | Article |
| Language: | English |
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Medical Journals Sweden
2023-02-01
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| Series: | Acta Orthopaedica |
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| Online Access: | https://actaorthop.org/actao/article/view/8480 |
| _version_ | 1797935001499598848 |
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| author | Maria Sigurdardottir Martin Ingi Sigurdsson Yngvi Olafsson Solveig H Sverrisdottir Ingibjorg Gunnarsdottir Emil L Sigurdsson Sigurbergur Karason |
| author_facet | Maria Sigurdardottir Martin Ingi Sigurdsson Yngvi Olafsson Solveig H Sverrisdottir Ingibjorg Gunnarsdottir Emil L Sigurdsson Sigurbergur Karason |
| author_sort | Maria Sigurdardottir |
| collection | DOAJ |
| description |
Background and purpose: The aim of this study was to identify the prevalence of modifiable risk factors of surgical site infections (SSI) in patients undergoing primary elective total joint arthroplasty (TJA) receiving conventional preoperative preparation, and to explore their association with infectious outcomes.
Patients and methods: Information regarding modifiable risk factors (anemia, diabetes, obesity, nutritional status, smoking, physical activity) was prospectively gathered in patients undergoing primary TJA of hip or knee in 2018–2020 at a single institution with 6 weeks’ follow-up time.
Results: 738 patients (median age 68 years [IQR 61–73], women 57%) underwent TJA (knee 64%, hip 36%). Anemia was detected in 8%, diabetes was present in 9%, an additional 2% had undiagnosed diabetes (HbA1c > 47 mmol/mol), and 8% dysglycemia (HbA1c 42–47 mmol/mol). Obesity (BMI ≥ 30) was observed in 52%. Serum albumin, total lymphocyte count, and vitamin D below normal limits was identified in 0.1%, 18%, and 16%, respectively. Current smokers were 7%. Surgical site complications occurred in 116 (16%), superficial SSI in 57 (8%), progressing to periprosthetic joint infection in 7 cases. Univariate analysis identified higher odds of superficial SSI for BMI ≥ 30 (OR 2.1, 95%CI 1.2–3.8) and HbA1c ≥ 42 mmol/mol (OR 2.2, CI 1.1–4.2), but no association was found with other factors.
Conclusion: In a general population undergoing primary TJA an association was found between obesity (52%) and dysglycemia/diabetes (19%) and superficial SSI (8%), which progressed to PJI in 12% of cases, generating a 1% total rate of PJI. Modification of these risk factors might mitigate infectious adverse outcomes.
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| first_indexed | 2024-04-10T18:07:45Z |
| format | Article |
| id | doaj.art-f693e342cd3a4eac9f579f025f7f594d |
| institution | Directory Open Access Journal |
| issn | 1745-3674 1745-3682 |
| language | English |
| last_indexed | 2024-04-10T18:07:45Z |
| publishDate | 2023-02-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Acta Orthopaedica |
| spelling | doaj.art-f693e342cd3a4eac9f579f025f7f594d2023-02-02T12:44:39ZengMedical Journals SwedenActa Orthopaedica1745-36741745-36822023-02-019410.2340/17453674.2023.8480Prevalence of modifiable risk factors in primary elective arthroplasty and their association with infectionsMaria Sigurdardottir0Martin Ingi Sigurdsson1Yngvi Olafsson2Solveig H Sverrisdottir3Ingibjorg Gunnarsdottir4Emil L Sigurdsson5Sigurbergur Karason6Department of Anaesthesia and Intensive Care, Landspitali, The National University Hospital of Iceland, Reykjavik; University of Iceland, Faculty of Medicine, ReykjavikDepartment of Anaesthesia and Intensive Care, Landspitali, The National University Hospital of Iceland, Reykjavik; University of Iceland, Faculty of Medicine, ReykjavikDepartment of Orthopeadics, Landspitali, The National University Hospital of Iceland, ReykjavikDepartment of Surgery, The National University Hospital of IcelandDepartment of Clinical Nutrition, Landspitali – The National University Hospital of Iceland, Reykjavik; University of Iceland, Faculty of Food Science and NutritionUniversity of Iceland, Faculty of Medicine, Reykjavik; Development Centre for Primary Health Care in IcelandDepartment of Anaesthesia and Intensive Care, Landspitali, The National University Hospital of Iceland, Reykjavik; University of Iceland, Faculty of Medicine, Reykjavik Background and purpose: The aim of this study was to identify the prevalence of modifiable risk factors of surgical site infections (SSI) in patients undergoing primary elective total joint arthroplasty (TJA) receiving conventional preoperative preparation, and to explore their association with infectious outcomes. Patients and methods: Information regarding modifiable risk factors (anemia, diabetes, obesity, nutritional status, smoking, physical activity) was prospectively gathered in patients undergoing primary TJA of hip or knee in 2018–2020 at a single institution with 6 weeks’ follow-up time. Results: 738 patients (median age 68 years [IQR 61–73], women 57%) underwent TJA (knee 64%, hip 36%). Anemia was detected in 8%, diabetes was present in 9%, an additional 2% had undiagnosed diabetes (HbA1c > 47 mmol/mol), and 8% dysglycemia (HbA1c 42–47 mmol/mol). Obesity (BMI ≥ 30) was observed in 52%. Serum albumin, total lymphocyte count, and vitamin D below normal limits was identified in 0.1%, 18%, and 16%, respectively. Current smokers were 7%. Surgical site complications occurred in 116 (16%), superficial SSI in 57 (8%), progressing to periprosthetic joint infection in 7 cases. Univariate analysis identified higher odds of superficial SSI for BMI ≥ 30 (OR 2.1, 95%CI 1.2–3.8) and HbA1c ≥ 42 mmol/mol (OR 2.2, CI 1.1–4.2), but no association was found with other factors. Conclusion: In a general population undergoing primary TJA an association was found between obesity (52%) and dysglycemia/diabetes (19%) and superficial SSI (8%), which progressed to PJI in 12% of cases, generating a 1% total rate of PJI. Modification of these risk factors might mitigate infectious adverse outcomes. https://actaorthop.org/actao/article/view/8480ArthroplastyHipInfectionKneeModifiable risk factors Periprosthetic joint infection |
| spellingShingle | Maria Sigurdardottir Martin Ingi Sigurdsson Yngvi Olafsson Solveig H Sverrisdottir Ingibjorg Gunnarsdottir Emil L Sigurdsson Sigurbergur Karason Prevalence of modifiable risk factors in primary elective arthroplasty and their association with infections Acta Orthopaedica Arthroplasty Hip Infection Knee Modifiable risk factors Periprosthetic joint infection |
| title | Prevalence of modifiable risk factors in primary elective arthroplasty and their association with infections |
| title_full | Prevalence of modifiable risk factors in primary elective arthroplasty and their association with infections |
| title_fullStr | Prevalence of modifiable risk factors in primary elective arthroplasty and their association with infections |
| title_full_unstemmed | Prevalence of modifiable risk factors in primary elective arthroplasty and their association with infections |
| title_short | Prevalence of modifiable risk factors in primary elective arthroplasty and their association with infections |
| title_sort | prevalence of modifiable risk factors in primary elective arthroplasty and their association with infections |
| topic | Arthroplasty Hip Infection Knee Modifiable risk factors Periprosthetic joint infection |
| url | https://actaorthop.org/actao/article/view/8480 |
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