Infection control and hospital epidemiology · 2015
Surgical site infection after primary hip and knee arthroplasty: a cohort study using a hospital database.
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Grammatico-Guillon Leslie, Baron Sabine, Rosset Philippe, Gaborit Christophe, Bernard Louis, Rusch Emmanuel, Astagneau Pascal
Аннотация
BACKGROUND: Hip or knee arthroplasty infection (HKAI) leads to heavy medical consequences even if rare.
OBJECTIVE: To assess the routine use of a hospital discharge detection algorithm of prosthetic joint infection as a novel additional tool for surveillance.
METHODS: A historic 5-year cohort study was built using a hospital database of people undergoing a first hip or knee arthroplasty in 1 French region (2.5 million inhabitants, 39 private and public hospitals): 32,678 patients with arthroplasty code plus corresponding prosthetic material code were tagged. HKAI occurrence was then tracked in the follow-up on the basis of a previously validated algorithm using International Statistical Classification of Disease, Tenth Revision, codes as well as the surgical procedures coded. HKAI density incidence was estimated during the follow-up (up to 4 years after surgery); risk factors were analyzed using Cox regression.
RESULTS: A total of 604 HKAI patients were identified: 1-year HKAI incidence was1.31%, and density incidence was 2.2/100 person-years in hip and 2.5/100 person-years in knee. HKAI occurred within the first 30 days after surgery for 30% but more than 1 year after replacement for 29%. Patients aged 75 years or older, male, or having liver diseases, alcohol abuse, or ulcer sore had higher risk of infection. The inpatient case fatality in HKAI patients was 11.4%.
CONCLUSIONS: The hospital database method used to measure occurrence and risk factors of prosthetic joint infection helped to survey HKAI and could optimize healthcare delivery.
OBJECTIVE: To assess the routine use of a hospital discharge detection algorithm of prosthetic joint infection as a novel additional tool for surveillance.
METHODS: A historic 5-year cohort study was built using a hospital database of people undergoing a first hip or knee arthroplasty in 1 French region (2.5 million inhabitants, 39 private and public hospitals): 32,678 patients with arthroplasty code plus corresponding prosthetic material code were tagged. HKAI occurrence was then tracked in the follow-up on the basis of a previously validated algorithm using International Statistical Classification of Disease, Tenth Revision, codes as well as the surgical procedures coded. HKAI density incidence was estimated during the follow-up (up to 4 years after surgery); risk factors were analyzed using Cox regression.
RESULTS: A total of 604 HKAI patients were identified: 1-year HKAI incidence was1.31%, and density incidence was 2.2/100 person-years in hip and 2.5/100 person-years in knee. HKAI occurred within the first 30 days after surgery for 30% but more than 1 year after replacement for 29%. Patients aged 75 years or older, male, or having liver diseases, alcohol abuse, or ulcer sore had higher risk of infection. The inpatient case fatality in HKAI patients was 11.4%.
CONCLUSIONS: The hospital database method used to measure occurrence and risk factors of prosthetic joint infection helped to survey HKAI and could optimize healthcare delivery.
Предметные рубрики MeSH
AdolescentAdultAgedAged, 80 and overAlgorithmsArthroplasty, Replacement, HipArthroplasty, Replacement, KneeDatabases, FactualFemaleFollow-Up StudiesFranceHip ProsthesisHumansIncidenceKnee ProsthesisMaleMiddle AgedPatient DischargePopulation SurveillanceProsthesis-Related InfectionsRetrospective StudiesRisk FactorsSurgical Wound InfectionYoung Adult