Impact of department volume on surgical site infections following arthroscopy, knee replacement or hip replacement

Meyer, Elisabeth; Weitzel-Kage, D.; Sohr, Dorit; Gastmeier, Petra

doi:10.1136/bmjqs.2011.051250

Cited by 46 publications

(28 citation statements)

References 31 publications

(24 reference statements)

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“…There are many unclear views about THA-related health outcomes with respect to socio-economic value [11][12][13][14], medical characteristics of patients [15], hospital volume [16,17], type of rehabilitation [18], etc. In addition to professional discrepancies towards these aspects, orthopaedic surgical practice is also not consensual on the choice of endoprosthetic fixation or the surgical access to hip [19,20].…”

Section: Introductionmentioning

confidence: 99%

Primary total hip arthroplasty: health related quality of life outcomes

Bagarić

Šarac

Borovac

et al. 2013

International Orthopaedics (SICOT)

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Purpose The health related quality of life (HRQoL) outcomes of total hip arthroplasty (THA) present a pertinent and clinically important problem in modern orthopaedics. Our goal was to report and compare the health-related outcomes after THA in respect to type of fixation in patients with hip osteoarthritis (H-OA) one year after operation. Methods A total of 145 patients with H-OA who received THA were evaluated. Uncemented and cemented subjects were evaluated using generic measures, i.e. the EQ-5D

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Section: Introductionmentioning

confidence: 99%

Primary total hip arthroplasty: health related quality of life outcomes

Bagarić

Šarac

Borovac

et al. 2013

International Orthopaedics (SICOT)

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“…This variable showed a statistically significant difference between the group with infection and the group with no infection when tested association with SSI, and this result is corroborated by other researches. (17,19,20) The presence of chronic diseases was also investigated, the types found were diabetes and obesity. Although the results of the research showed no association with SSI, in literature this variable is a risk factor for the occurrence of SSI.…”

Section: Discussionmentioning

confidence: 99%

Ocorrência e fatores de risco para infecção de sítio cirúrgico em cirurgias ortopédicas

et al. 2013

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Objective: To analyze the occurrence and risk factors for surgical site infection in patients undergoing orthopedic surgery. Methods: A prospective cross-sectional study with 93 patients undergoing elective and clean orthopedic surgery. Results: The surgical site infection was diagnosed in 16 patients (17.2%). In data analysis, after adjusting the binary logistic regression model, only the variable total time of hospitalization was statistically significant with respect to the presence or absence of infection. Conclusion: The occurrence of surgical site infection in orthopedic surgery was higher, with 75% of cases diagnosed after hospital discharge, this result reinforces the need for post-discharge surveillance. ResumoObjetivo: Analisar a ocorrência e os fatores de risco para infecção de sítio cirúrgico em pacientes submetidos a cirurgias ortopédicas. Métodos: Estudo transversal prospectivo com 93 pacientes submetidos a cirurgias ortopédicas eletivas e limpas. Resultados: A infecção de sítio cirúrgico foi diagnosticada em 16 pacientes (17,2%). Na análise dos dados, após ajuste do modelo de regressão logística binária, apenas a variável tempo total de internação mostrou-se com relação estatisticamente significativa com a presença ou não de infecção. Conclusão: A ocorrência de infecção de sítio cirúrgico em cirurgia ortopédica foi mais elevada, sendo 75% dos casos diagnosticados após a alta hospitalar, resultado que reforça a necessidade da vigilância pós-alta.

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“…9,11,14,[16][17][18][19][20] A low hospital volume has been associated with a higher risk of PJI. 10,14,16,17,20 However, one study reported a higher risk in hospitals with an annual volume of >200 cases compared with hospitals with an annual volume of <100 cases. 11 This study evaluated the incidence and risk factors of PJI in patients undergoing TKA in a high-volume hospital.…”

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confidence: 99%

“…11,14,17,18 The association between hospital volume and infection rate is controversial. 11,17 Hospital volume appears less important than surgeon volume for risk of PJI and other complications.…”

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confidence: 99%

“…[7][8][9][10][11][12][13][14] Risk factors include patients factors such as young age, male sex, high body mass index, diabetes mellitus, preoperative comorbidities, previous knee surgeries, and rheumatoid arthritis, [7][8][9][10][11][12][13]15,16 as well as surgical factors such as operative time, surgeon volume, and hospital volume. 9,11,14,[16][17][18][19][20] A low hospital volume has been associated with a higher risk of PJI. 10,14,16,17,20 However, one study reported a higher risk in hospitals with an annual volume of >200 cases compared with hospitals with an annual volume of <100 cases.…”

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confidence: 99%

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Risk Factors for Periprosthetic Joint Infection in Total Knee Arthroplasty

Lee¹,

Mak²,

Wong³

2015

J Orthop Surg (Hong Kong)

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Purpose. To evaluate the incidence and risk factors of periprosthetic joint infection (PJI) in patients undergoing total knee arthroplasty (TKA) in a highvolume hospital. Methods. Records of 1133 primary TKAs were reviewed. Correlation between surgery volume and infection rate was determined. Risk factors for PJI were identified using case-control analysis of variables. TKAs performed between October 2012 and March 2013 without infection were used as controls. Results. Of 1133 TKAs, 8 (0.71%) PJI occurred. The organisms involved were Staphylococcus aureus (n=4), coagulase-negative staphylococci (n=2), Pseudomonas aeruginosa (n=1), and methicillin-resistant S aureus (n=1). In the 6-month period chosen as the control period, one (0.52%) out of 192 TKAs developed PJI. Hospital annual volume did not correlate with infection rate (p=0.766). Significant risk factors included young age, comorbidities such as diabetes,

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Impact of department volume on surgical site infections following arthroscopy, knee replacement or hip replacement

Abstract: The authors' findings offer some support for recommendations to concentrate arthroscopy and knee replacement in surgical departments with more than 50 procedures and hip replacement in departments with more than 100 procedures per year in order to reduce SSI.

Cited by 46 publications

References 31 publications

Primary total hip arthroplasty: health related quality of life outcomes

Primary total hip arthroplasty: health related quality of life outcomes

Ocorrência e fatores de risco para infecção de sítio cirúrgico em cirurgias ortopédicas

Risk Factors for Periprosthetic Joint Infection in Total Knee Arthroplasty

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