Preoperative and perioperative risk factors, and risk score development for prosthetic joint infection due to Staphylococcus aureus : a multinational matched case-control study
Published by Elsevier Ltd..
OBJECTIVES: We aim to identify the preoperative and perioperative risk factors associated with post-surgical Staphylococcus aureus prosthetic joint infections (PJI) and to develop and validate risk-scoring systems, to allow a better identification of high-risk patients for more efficient targeted interventions.
METHODS: We performed a multicenter matched case-control study of patients who underwent a primary hip and knee arthroplasty from 2014 to 2016. Two multivariable models by logistic regression were performed, one for the preoperative and one for perioperative variables; predictive scores also were developed and validated in an external cohort.
RESULTS: In total, 130 cases and 386 controls were included. The variables independently associated with S. aureus-PJI in the preoperative period were (adjusted OR; 95% CI): body mass index >30 kg/m2 (3.0; 1.9 to 4.8), resident in a long-term care facility (2.8; 1.05 to 7.5), fracture as reason for arthroplasty (2.7; 1.4 to 5.03), skin disorders (2.5; 0.9 to 7.04), previous surgery in the index joint (2.4; 1.3 to 4.4), male sex (1.9; 1.2 to 2.9) and American Society of Anesthesiologists index score 3 to 4 (1.8; 1.2 to 2.9). The area under the receiver operating characteristic curve was 0.73 (95% CI 0.68 to 0.78). In perioperative model, the risk factors were the previous ones plus surgical antibiotic prophylaxis administered out of the first 60 minutes before incision (5.9; 2.1 to 16.2), wound drainage for >72 hours after arthroplasty (4.5; 1.9 to 19.4) and use of metal bearing material versus ceramic (1.9; 1.1 to 3.3). The area under the receiver operating characteristic curve was 0.78 (95% CI 0.72 to 0.83). The predictive scores developed were validated in the external cohort.
DISCUSSION: Predictive scores for S. aureus-PJI were developed and validated; this information would be useful for implementation of specific preventive measures.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:28 |
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| Enthalten in: |
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases - 28(2022), 10 vom: 15. Okt., Seite 1359-1366 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Espindola, Reinaldo [VerfasserIn] |
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| Links: |
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| Themen: |
Arthroplasty |
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| Anmerkungen: |
Date Completed 28.09.2022 Date Revised 28.09.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.cmi.2022.05.010 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 245 | 1 | 0 | |a Preoperative and perioperative risk factors, and risk score development for prosthetic joint infection due to Staphylococcus aureus |b a multinational matched case-control study |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Published by Elsevier Ltd. | ||
| 520 | |a OBJECTIVES: We aim to identify the preoperative and perioperative risk factors associated with post-surgical Staphylococcus aureus prosthetic joint infections (PJI) and to develop and validate risk-scoring systems, to allow a better identification of high-risk patients for more efficient targeted interventions | ||
| 520 | |a METHODS: We performed a multicenter matched case-control study of patients who underwent a primary hip and knee arthroplasty from 2014 to 2016. Two multivariable models by logistic regression were performed, one for the preoperative and one for perioperative variables; predictive scores also were developed and validated in an external cohort | ||
| 520 | |a RESULTS: In total, 130 cases and 386 controls were included. The variables independently associated with S. aureus-PJI in the preoperative period were (adjusted OR; 95% CI): body mass index >30 kg/m2 (3.0; 1.9 to 4.8), resident in a long-term care facility (2.8; 1.05 to 7.5), fracture as reason for arthroplasty (2.7; 1.4 to 5.03), skin disorders (2.5; 0.9 to 7.04), previous surgery in the index joint (2.4; 1.3 to 4.4), male sex (1.9; 1.2 to 2.9) and American Society of Anesthesiologists index score 3 to 4 (1.8; 1.2 to 2.9). The area under the receiver operating characteristic curve was 0.73 (95% CI 0.68 to 0.78). In perioperative model, the risk factors were the previous ones plus surgical antibiotic prophylaxis administered out of the first 60 minutes before incision (5.9; 2.1 to 16.2), wound drainage for >72 hours after arthroplasty (4.5; 1.9 to 19.4) and use of metal bearing material versus ceramic (1.9; 1.1 to 3.3). The area under the receiver operating characteristic curve was 0.78 (95% CI 0.72 to 0.83). The predictive scores developed were validated in the external cohort | ||
| 520 | |a DISCUSSION: Predictive scores for S. aureus-PJI were developed and validated; this information would be useful for implementation of specific preventive measures | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Arthroplasty | |
| 650 | 4 | |a Case-control study | |
| 650 | 4 | |a Multinational study | |
| 650 | 4 | |a Prosthetic joint infection | |
| 650 | 4 | |a Risk factors | |
| 650 | 4 | |a Staphylococcus aureus | |
| 700 | 1 | |a Vella, Venanzio |e verfasserin |4 aut | |
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| 700 | 1 | |a Hendriks, Johannes G E |e verfasserin |4 aut | |
| 700 | 1 | |a Sorlí, Luisa |e verfasserin |4 aut | |
| 700 | 1 | |a Murillo, Oscar |e verfasserin |4 aut | |
| 700 | 1 | |a Scarborough, Mathew |e verfasserin |4 aut | |
| 700 | 1 | |a Scarborough, Claire |e verfasserin |4 aut | |
| 700 | 1 | |a Kluytmans, Jan |e verfasserin |4 aut | |
| 700 | 1 | |a Ferrari, Mateo Carlo |e verfasserin |4 aut | |
| 700 | 1 | |a Pletz, Mathias W |e verfasserin |4 aut | |
| 700 | 1 | |a Mcnamara, Iain |e verfasserin |4 aut | |
| 700 | 1 | |a Escudero-Sanchez, Rosa |e verfasserin |4 aut | |
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| 700 | 1 | |a Cinconze, Elisa |e verfasserin |4 aut | |
| 700 | 1 | |a Pellegrini, Michele |e verfasserin |4 aut | |
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| 700 | 1 | |a Junyent, Joan Gómez |e investigator |4 oth | |
| 700 | 1 | |a Alier, Albert |e investigator |4 oth | |
| 700 | 1 | |a Soldevila, Laura |e investigator |4 oth | |
| 700 | 1 | |a van Rijen, Miranda |e investigator |4 oth | |
| 700 | 1 | |a Romme, Jannie |e investigator |4 oth | |
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