Mortality During Total Knee Periprosthetic Joint Infection
| Autor: | Gavin Pereira, Trevor J. Shelton, Mauro Giordani, John P. Meehan, Zachary C. Lum, Kyle M. Natsuhara |
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| Rok vydání: | 2018 |
| Předmět: |
Reoperation
Arthritis Infectious 030222 orthopedics medicine.medical_specialty Prosthesis-Related Infections Knee Joint business.industry Mortality rate Total hip replacement Periprosthetic Disease Odds ratio Total knee 03 medical and health sciences Total hip revision 0302 clinical medicine Internal medicine Odds Ratio Risk of mortality Humans Medicine Orthopedics and Sports Medicine 030212 general & internal medicine Arthroplasty Replacement Knee business |
| Zdroj: | The Journal of Arthroplasty. 33:3783-3788 |
| ISSN: | 0883-5403 |
| Popis: | Periprosthetic joint infections (PJIs) are fraught with multiple complications including poor patient-reported outcomes, disability, reinfection, disarticulation, and even death. We sought to perform a systematic review asking the question: (1) What is the mortality rate of a PJI of the knee undergoing 2-stage revision for infection? (2) Has this rate improved over time? (3) How does this compare to a normal cohort of individuals?We performed a database search in MEDLINE/EMBASE, PubMed, and all relevant reference studies using the following keywords: "periprosthetic joint infection," "mortality rates," "total knee arthroplasty," and "outcomes after two stage revision." Two hundred forty-two relevant studies and citations were identified, and 14 studies were extracted and included in the review.A total of 20,719 patients underwent 2-stage revision for total knee PJI. Average age was 66 years. Mean mortality percentage reported was 14.4% (1.7%-34.0%) with average follow-up 3.8 years (0.25-9 years). One-year mortality rate was 4.33% (3.14%-5.51%) after total knee PJI with an increase of 3.13% per year mortality thereafter (r = 0.76 [0.49, 0.90], P.001). Five-year mortality was 21.64%. When comparing the national age-adjusted mortality (Actuarial Life Table) and the reported 1-year mortality risk in this meta-analysis, the risk of death after total knee PJI is significantly increased, with an odds ratio of 3.05 (95% confidence interval, 2.69-3.44; P.001).The mortality rate after 2-stage total knee revision for infection is very high. When counseling a patient regarding complications of this disease, death should be discussed. |
| Databáze: | OpenAIRE |
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