Systematic review of risk prediction studies in bone and joint infection: are modifiable prognostic factors useful in predicting recurrence?
| Autor: | Martin A. McNally, Maria Dudareva, Andrew J Hotchen, Gary S. Collins, Jamie Hartmann-Boyce, Matthew Scarborough |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Orthopedic surgery
030222 orthopedics medicine.medical_specialty business.industry Causal effect MEDLINE Odds ratio Review medicine.disease Obesity Smoking history 03 medical and health sciences Malnutrition 0302 clinical medicine Infectious Diseases medicine Orthopedics and Sports Medicine Surgery 030212 general & internal medicine Intensive care medicine business Body mass index RD701-811 Cohort study |
| Zdroj: | Journal of Bone and Joint Infection, Vol 6, Pp 257-271 (2021) Journal of Bone and Joint Infection Journal of Bone and Joint Infection, 6 (7) |
| ISSN: | 2206-3552 |
| Popis: | Background: Classification systems for orthopaedic infection include patient health status, but there is no consensus about which comorbidities affect prognosis. Modifiable factors including substance use, glycaemic control, malnutrition and obesity may predict post-operative recovery from infection. Aim: This systematic review aimed (1) to critically appraise clinical prediction models for individual prognosis following surgical treatment for orthopaedic infection where an implant is not retained; (2) to understand the usefulness of modifiable prognostic factors for predicting treatment success. Methods: EMBASE and MEDLINE databases were searched for clinical prediction and prognostic studies in adults with orthopaedic infections. Infection recurrence or re-infection after at least 6 months was the primary outcome. The estimated odds ratios for the primary outcome in participants with modifiable prognostic factors were extracted and the direction of the effect reported. Results: Thirty-five retrospective prognostic cohort studies of 92 693 patients were included, of which two reported clinical prediction models. No studies were at low risk of bias, and no externally validated prediction models were identified. Most focused on prosthetic joint infection. A positive association was reported between body mass index and infection recurrence in 19 of 22 studies, similarly in 8 of 14 studies reporting smoking history and 3 of 4 studies reporting alcohol intake. Glycaemic control and malnutrition were rarely considered. Conclusion: Modifiable aspects of patient health appear to predict outcomes after surgery for orthopaedic infection. There is a need to understand which factors may have a causal effect. Development and validation of clinical prediction models that include participant health status will facilitate treatment decisions for orthopaedic infections. Journal of Bone and Joint Infection, 6 (7) |
| Databáze: | OpenAIRE |
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