Preoperative Opioids Increase the Risk of Periprosthetic Joint Infection After Total Joint Arthroplasty
| Autor: | Javad Parvizi, Kerri L. Bell, Timothy L. Tan, Karan Goswami, Noam Shohat, Irene L. Kalbian |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Prosthesis-Related Infections Multivariate analysis Arthroplasty Replacement Hip medicine.medical_treatment Periprosthetic Cohort Studies 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Odds Ratio medicine Humans Orthopedics and Sports Medicine Arthroplasty Replacement Knee Aged Retrospective Studies Philadelphia 030203 arthritis & rheumatology Arthritis Infectious 030222 orthopedics business.industry Incidence Incidence (epidemiology) Odds ratio Middle Aged Arthroplasty Confidence interval Analgesics Opioid Cohort Female business Cohort study |
| Zdroj: | The Journal of Arthroplasty. 33:3246-3251.e1 |
| ISSN: | 0883-5403 |
| Popis: | Background Opioids have well-known immunosuppressive properties and preoperative opioid consumption is relatively common among patients undergoing total joint arthroplasty (TJA). The hypothesis of this study was that utilization of opioids preoperatively would increase the incidence of subsequent periprosthetic joint infection (PJI) in patients undergoing primary TJA. Methods A comparative cohort study design was set up that used a cohort of 23,754 TJA patients at a single institution. Patient records were reviewed to extract relevant information, in particular details of opioid consumption, and an internal institutional database of PJI was cross-referenced against the cohort to identify patients who developed a PJI within 2 years of index arthroplasty. Univariate and multivariate linear regression analyses were used to examine the potential association between preoperative opioid consumption and the development of PJI. Results Among the total cohort of 23,754 patients, 5051 (21.3%) patients used opioids before index arthroplasty. Preoperative opioid usage overall was found to be a significant risk factor for development of PJI in the univariate (odds ratio, 1.63; P = .005) and multivariate analyses (adjusted odds ratio, 1.53 [95% confidence interval, 1.14-2.05], P = .005). Conclusion Preoperative opioid consumption is independently associated with a higher risk of developing a PJI after primary TJA. These findings underscore a need for caution when prescribing opioids in patients with degenerative joint disease who may later require arthroplasty. |
| Databáze: | OpenAIRE |
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