Preoperative and perioperative risk factors, and risk score development for prosthetic joint infection due to Staphylococcus aureus: a multinational matched case-control study
| Autor: | Reinaldo Espindola, Venanzio Vella, Natividad Benito, Isabel Mur, Sara Tedeschi, Nicolò Rossi, Johannes G.E. Hendriks, Luisa Sorlí, Oscar Murillo, Mathew Scarborough, Claire Scarborough, Jan Kluytmans, Mateo Carlo Ferrari, Mathias W. Pletz, Iain Mcnamara, Rosa Escudero-Sanchez, Cedric Arvieux, Cecile Batailler, Frédéric-Antoine Dauchy, Wai-Yan Liu, Jaime Lora-Tamayo, Julia Praena, Andrew Ustianowski, Elisa Cinconze, Michele Pellegrini, Fabio Bagnoli, Jesús Rodríguez-Baño, Maria Dolores Del Toro, Nienke Cuperus, Giuseppe Manfré, Eleonora Zamparini, Stéphanie Verhagen, Juan P. Horcajada, Joan Gómez Junyent, Albert Alier, Laura Soldevila, Miranda van Rijen, Jannie Romme, Juliane Ankert, Celia Whitehouse, Adrian Jones, Javier Cobo, Javier Moreno, Anne Meheut, Claire Gledel, Pauline Perreau, Remco J.A. van Wensen, Gabriella Lindergard |
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| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
Microbiology (medical)
Male Arthritis Infectious Prosthetic joint infection Staphylococcus aureus Prosthesis-Related Infections Arthroplasty Replacement Hip Multinational study Case-control study General Medicine Staphylococcal Infections Arthroplasty Infectious Diseases Risk factors Case-Control Studies Humans Retrospective Studies |
| Popis: | [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. |
| Databáze: | OpenAIRE |
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