Clinical outcome and risk factors for failure in late acute prosthetic joint infections treated with debridement and implant retention.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Wouthuyzen-Bakker Marjan, Sebillotte Marine, Lomas Jose, Taylor Adrian, Palomares Eva Benavent, Murillo Oscar, Parvizi Javad, Shohat Noam, Reinoso Javier Cobo, Sánchez Rosa Escudero, Fernandez-Sampedro Marta, Senneville Eric, Huotari Kaisa, Barbero José Maria, Garcia-Cañete Joaquín, Lora-Tamayo Jaime, Ferrari Matteo Carlo, Vaznaisiene Danguole, Yusuf Erlangga, Aboltins Craig, Trebse Rihard, Salles Mauro José, Benito Natividad, Vila Andrea, Toro Maria Dolores Del, Kramer Tobias Siegfried, Petersdorf Sabine, Diaz-Brito Vicens, Tufan Zeliha Kocak, Sanchez Marisa, Arvieux Cédric, Soriano Alex, ESCMID Study Group for Implant-Associated Infections (ESGIAI)
Аннотация
METHODS: Patients diagnosed with LA PJI between 2005 and 2015 were retrospectively evaluated. LA PJI was defined as the development of acute symptoms (≤ 3 weeks) occurring ≥ 3 months after arthroplasty. Failure was defined as: (i) the need for implant removal, (ii) infection related death, (iii) the need for suppressive antibiotic therapy and/or (iv) relapse or reinfection during follow-up.
RESULTS: 340 patients from 27 centers were included. The overall failure rate was 45.0% (153/340). Failure was dominated by Staphylococcus aureus PJI (54.7%, 76/139). Significant independent preoperative risk factors for failure according to the multivariate analysis were: fracture as indication for the prosthesis (odds ratio (OR) 5.4), rheumatoid arthritis (OR 5.1), age above 80 years (OR 2.6), male gender (OR 2.0) and C-reactive protein > 150 mg/L (OR 2.0). Exchanging the mobile components during DAIR was the strongest predictor for treatment success (OR 0.35).
CONCLUSION: LA PJIs have a high failure rate. Treatment strategies should be individualized according to patients' age, comorbidity, clinical presentation and microorganism causing the infection.