Incidence of Infection and Inhospital Mortality in Patients With Chronic Renal Failure After Total Joint Arthroplasty

October 29, 2016 at 10:27 am

Journal of Arthroplasty November 2016 V.31 N.11 P.2473-2441

Omer F. Erkocak, Joanne Y. Yoo, Camilo Restrepo, Mitchell G. Maltenfort, Javad Parvizi

Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania

Background

Patients with chronic renal failure (CRF) may require total joint arthroplasty (TJA) to treat degenerative joint disease, fractures, osteonecrosis, or amyloid arthropathy. There have been conflicting results, however, regarding outcomes of TJA in patients with chronic renal disease. The aim of this case-controlled study was to determine the outcome of TJA in patients with CRF, with particular interest in the incidence of infections and inhospital mortality.

Methods

We queried our electronic database to determine which patients among the 29,389 TJAs performed at our institution between January 2000 and June 2012 had a diagnosis of CRF. A total of 359 CRF patients were identified and matched for procedure, gender, age (±4 years), date of surgery (±2 years), and body mass index (±5 kg/m2) in a 2:1 ratio to 718 control patients.

Results

The incidence of infection and inhospital mortality was not significantly different between the nondialysis CRF patients and controls, whereas it was significantly higher in dialysis-dependent end-stage renal failure patients compared to controls. Of the 50 CRF patients receiving hemodialysis, 10 (20%) developed surgical site infection, of which 4 (8%) were periprosthetic joint infection, and 4 (8%) died during hospital stay. The odds ratio for infection in the dialysis group was 7.54 (95% confidence interval: 2.83-20.12) and 10.46 (95% confidence interval: 1.67-65.34) for the inhospital mortality.

Conclusion

We conclude that end-stage renal failure patients receiving hemodialysis have higher postoperative infection and inhospital mortality rates after an elective TJA procedure, whereas nondialysis CRF patients have similar outcomes compared with the general TJA population.

PDF

http://www.arthroplastyjournal.org/article/S0883-5403(16)30130-9/pdf

Entry filed under: Antimicrobianos, Bacterias, Bacteriemias, FIEBRE en el POSTOPERATORIO, Health Care-Associated Infections, HIC no SIDA, Infecciones e Insuf. renal, Infecciones nosocomiales, Infecciones osteo-articulares-musculares, Infecciones relacionadas a prótesis, Infecciones sitio quirurgico, Metodos diagnosticos, REPORTS, Sepsis, Update. Tags: .

Implementing an Antibiotic Stewardship Program: Guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America Concomitant Multiple Joint Arthroplasty Infections: Report on 16 Cases


Calendar

October 2016
M T W T F S S
« Sep   Nov »
 12
3456789
10111213141516
17181920212223
24252627282930
31  

Most Recent Posts


%d bloggers like this: