Incidence and risk factors of surgical site infection after total knee arthroplasty: Results of a retrospective cohort study

Baier, Claas; Adelmund, Simon; Schwab, Frank J.; Lassahn, C.; Chaberny, Iris F.; Gossé, F.; Vonberg, Ralf‐Peter; Ebadi, Ella

doi:10.1016/j.ajic.2019.04.010

Cited by 22 publications

(28 citation statements)

References 10 publications

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“…The results of this study demonstrated that malnutrition is a risk factor associated with the development of SSI after primary TKA, and a similar result has been reported in several previous studies [11][12][13]. However, recently published large cohort studies contradicted this nding [22][23][24]. This contradiction may be ascribed to the different criteria for de ning malnutrition.…”

Section: Discussionsupporting

confidence: 88%

Can the Preoperative Prognostic Nutrition Index (PNI) Predict Surgical Site Infection Following Primary Total Knee Arthroplasty?

Shi

Deng³

et al. 2020

Preprint

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Background:Malnutrition is reported as one of the risk factors for surgical site infection (SSI). The prognostic nutritional index (PNI) is a simple method for nutritional evaluation. However, few studies have discussed the effectiveness of PNI as a nutritional assessment in predicting SSI after primary total knee arthroplasty (TKA). The aim of this study is to investigate the relationship between SSI and malnutrition as identified by the PNI scores following TKA. Methods: A retrospective analysis of 483 patients (SSI vs. non-SSI group: 19 vs. 464; follow-up period: at least 1 year) was performed to confirm the risk factors, including the PNI, associated with SSI after primary TKA using both univariate and multivariate analyses. Results: Postoperatively, nineteen patients (19/483, 3.9%) experienced SSI (deep vs. superficial SSI: 12 vs. 7), and periprosthetic joint infection was observed in all deep SSI cases. Univariate analysis showed that male sex, body weight, body mass index (BMI), diabetes mellitus, steroid usage, operative time and PNI differed between the SSI and non-SSI groups (P<0.05). Multivariate logistic regression analysis identified that the preoperative PNI (odds ratio [OR]: 0.859; 95% confidence interval [CI]: 0.762-0.969; cutoff [CV]: 49.27), operative time (OR: 1.005; 95% CI: 1.000-1.010; CV: 131.0 min), male sex (OR: 4.127; 95% CI: 1.165-14.615), diabetes mellitus (OR: 6.133; 95% CI: 2.067-18.193) and steroid usage (OR: 6.034; 95% CI: 1.521-23.935) were independently associated with SSI (P<0.05). Conclusions: A low preoperative PNI associated with malnutrition was demonstrated to be an independent risk factor for SSI following primary TKA. Patients with preoperative low PNI should be cautioned and provided with adequate nutritional intervention to reduce postoperative SSI.

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Section: Discussionsupporting

confidence: 88%

Can the Preoperative Prognostic Nutrition Index (PNI) Predict Surgical Site Infection Following Primary Total Knee Arthroplasty?

Shi

Deng³

et al. 2020

Preprint

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“…Forsythe et al 178 stated that smoking status (OR=1.7; 95% CI: 1.4-1.9) is an independent risk factor for SSI development. Baier et al 179 also revealed that smoking was an independent risk factor for postoperative SSI (OR=2.22; 95% CI: 1.27-3.90). One study showed that after surgery for adult spinal deformity and distal femoral fractures, the wound infection risk in the smoking group was higher than that of the non-smoking group 180,181 .…”

Section: Smoking and Surgical Site Infection (Ssi)mentioning

confidence: 94%

Smoking increases the risk of infectious diseases: A narrative review

Chen¹,

Chen²,

Xie³

2020

Tob. Induc. Dis.

115

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Smoking is one of the most severe public health problems in the world. According to the WHO Global report on trends in prevalence of tobacco use 2000-2025, smoking accounts for 9% of all deaths worldwide, and more than half of smokers die from smoking-related diseases 1. China is the largest producer and consumer of tobacco in the world. In 2018, about 26.6% of adults (aged ≥15 years; 308 million in total) were current smokers and 44.9% of adults (515 million) were exposed to secondhand smoke at home 1. Exposure to cigarette smoke and secondhand smoke is very harmful to human health. There are over 7000 chemical components in tobacco smoke, of these, over 250 are toxic or carcinogenic, such as aldehydes, nitrides, and others that irritate the respiratory tract. Nicotine leads to tobacco addiction; benzpyrene, arsenic, cadmium and other components have carcinogenic effects and nitric oxide can reduce oxygen transport by erythrocytes. Smoking can damage nearly all organs of the human body and is one of the main risk factors for respiratory infection and infectious diseases in other systems, in a dose-dependent manner 2,3. In this review, we discuss the mechanisms and influence of smoking on infections in various systems, including the respiratory system, digestive system, and genital system, among others, in order to provide evidence for the active promotion of smoking cessation. DEVELOPMENTS Mechanisms of susceptibility The potential mechanisms of how cigarette smoke increases the risk of systemic infections are not completely understood. These may include alteration ABSTRACT Smoking is relevant to infectious diseases resulting in increased prevalence and mortality. In this article, we aim to provide an overview of the effects of smoking in various infections and to explain the potential mechanisms. We searched PubMed and other relevant databases for scientific studies that explored the relationship between smoking and infection. The mechanisms of susceptibility to infection in smokers may include alteration of the structural, functional and immunologic host defences. Smoking is one of the main risk factors for infections in the respiratory tract, digestive tract, reproductive tract, and other systems in humans, increasing the prevalence of HIV, tuberculosis, SARS-CoV, and the current SARS-CoV-2. Smoking cessation can reduce the risk of infection. Smoking increases the incidence of infections and aggravates the progress and prognosis of infectious diseases in a dose-dependent manner. Smoking cessation promotion and education are the most practical and economical preventive measures to reduce aggravation of disease infection owing to tobacco use.

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“…There were significant differences in the concentrations of PM2.5 and PM10 between the two surgical smog types in the doctors' respiratory zone, and there was a significant difference between the two concentrations (all P < 0.001). Especially when the scalpel is turned on, the concentration of PM2.5 reached approximately 425.63 μg m -3 and 812.34μg m -3 , which indicated serious pollution, when regardless of the other affecting components of air quality .The ratio of PM10/PM2.5 was found to be close to one，the particulates in the surgical smoke were almost all PM2.5 (Baier et al, 2019).The PM2.5…”

Section: Accepted Manuscriptmentioning

confidence: 93%

“…1(C). It is an aerosol that consists of 95 % water and 5 % granulated cell debris (Baier et al, 2019). Studies have shown that a large number of harmful chemical components in surgical smoke, such as hydrocarbons, nitriles, organic amines, aldehydes and a small amount of hydrogen cyanide, formaldehyde, benzene, DNA(Moot et al, 2007).…”

Section: Surgical Smoke As Primary Pollution Sourcementioning

confidence: 99%

Study on Influencing Factors and Control Strategies of Surgical Smoke Concentration Distribution

Huang

Zhan

et al. 2020

Aerosol Air Qual. Res.

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Paroxysmal fumes during surgical operations endanger the health of medical staff. Special measures for removing surgical smoke are lacking. Article Real-time monitoring of particulate matter concentrations in surgical smoke at different locations under different surgical conditions were explored, and a particulate matter purification control strategy was proposed. The PM2.5 and PM10 concentrations in the operating and respiratory zones near the operating table were about 3.0 times more than the specified value, but both surgical procedures met the requirements of PM concentration in the public zone. Therefore, a clean operating room is not clean for medical staff. The smoke produced by the three scalpels resulted in particle sizes of 0.30-2.50 μm in the respiratory zone, and calculate apparent density of powders to be 1.21g cm-3. The surgical smoke produced by the ultrasound scalpel resulted in the highest median PM10 concentration in the operating area. The results show that the smoke produced by different surgical conditions is mainly ultra-fine particles, which are more likely to harm the health of medical staff. A small surgical smoke circulation purification and dust removal system was designed, which could effectively suppress the spread of surgical smoke and reduce the occupational hazards of medical staff. The optimized control plan could significantly reduce the PM2.5 concentration value at measurement point a when the electric knife was turned on by approximately 200.0 %. The PM2.5 concentration of breathing zone was close to 75.0 μg m-3 , which basically met the occupational health requirements. The decrease in the PM2.5 concentration of operating zone was about 50.0 %, but it still exceeded the limit. It had a reference value for the occupational health protection of the firstline medical staff of existing epidemics.

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Incidence and risk factors of surgical site infection after total knee arthroplasty: Results of a retrospective cohort study

Cited by 22 publications

References 10 publications

Can the Preoperative Prognostic Nutrition Index (PNI) Predict Surgical Site Infection Following Primary Total Knee Arthroplasty?

Can the Preoperative Prognostic Nutrition Index (PNI) Predict Surgical Site Infection Following Primary Total Knee Arthroplasty?

Smoking increases the risk of infectious diseases: A narrative review

Study on Influencing Factors and Control Strategies of Surgical Smoke Concentration Distribution

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