In-hospital Mortality after Septic Revision TKA: Analysis of the New York and Florida State Inpatient Databases.

Autor: Samuel LT; Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio., Sultan AA; Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio., Zhou G; Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, Ohio., Navale S; Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, Ohio., Kamath AF; Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio., Klika A; Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio., Piuzzi NS; Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio., Koroukian SM; Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, Ohio., Higuera-Rueda CA; Department of Orthopaedic Surgery, Cleveland Clinic Florida, Weston, Florida.
Jazyk: angličtina
Zdroj: The journal of knee surgery [J Knee Surg] 2022 Mar; Vol. 35 (4), pp. 416-423. Date of Electronic Publication: 2020 Aug 31.
DOI: 10.1055/s-0040-1715112
Abstrakt: The aims of this study were to investigate (1) in-hospital mortality rates following septic revision total knee arthroplasty (rTKA); (2) compare septic rTKA mortality rates between differing knee revision volume (KRV) hospitals; and (3) identify independent risk factors associated with in-hospital mortality after septic rTKA (up to 2-year follow-up). The Healthcare Cost and Utilization Project State Inpatient Databases of New York and Florida were used to identify septic rTKA, and control groups of aseptic rTKA and primary TKA between 2007 and 2012 via International Classification of Diseases, Ninth Revision codes. Mortality was compared between septic rTKA and aseptic rTKA/primary TKA control groups. Hospital KRV was stratified, and independent risk factors of in-hospital mortality were identified and analyzed using unadjusted and adjusted logistic regression analyses. In this study, 3,531 septic rTKA patients were identified; 105 (3%) patients suffered in-hospital mortality, compared with the control aseptic rTKA ( n  = 178; 1.7%; p  < 0.0001) and primary TKA groups ( n  = 930; 0.6%; p  < 0.0001). Being an octogenarian (adjusted odds ratio [AOR]: 2.361; 95% confidence interval [CI]: 1.514-3.683; p  < 0.0002) and having a medium- or high-Elixhauser comorbidity score was associated with in-hospital mortality (AOR: 2.073; 95% CI: 1.334-3.223; p  = 0.0012, and AOR: 4.127; 95% CI: 2.268-7.512, p  < 0.0001). There were no significant in-hospital mortality rate differences in high- versus medium- versus low-KRV hospitals (1.9 vs. 3.6 vs. 2.9%, respectively, p  = 0.0558). Age >81 years and higher comorbidity burden were found to contribute to increased risk of 2-year postoperative mortality after septic rTKA. This association could not be established for hospital KRV.
Competing Interests: N. S.P. reports other from ISCT, other from Journal of Hip Surgery, other from Journal of Knee Surgery, other from Orthopaedic Research Society, other from RegenLab, other from Zimmer, outside the submitted work; S. M. K. reports other from AAOS, other from American Association of Hip and Knee Surgeons, other from Anterior Hip Foundation, other from DePuy, A Johnson & Johnson Company, other from Innomed, other from Johnson & Johnson, other from Procter & Gamble, other from Signature Orthopaedics, other from Zimmer, outside the submitted work; A. F.K.reports other from American Renal Associates, other from Celgene, outside the submitted work.
(Thieme. All rights reserved.)
Databáze: MEDLINE
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