Infección periprótesica en pacientes ancianos tratados mediante hemiartroplastia de cadera tras fractura intracapsular. ¿Debemos usar cementación con antibiótico?

Aedo-Martín, Daniel; Crego-Vita, Diana; Cañas, R. García; Correa, Arisel; Sánchez-Pérez, Coral; Areta-Jiménez, Francisco Javier

doi:10.1016/j.recot.2019.07.005

Cited by 4 publications

(5 citation statements)

References 30 publications

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“…Data on the reduction of different infections by different measures are extremely scattered and limited. Some examples are the reduction by 53% of periprosthetic infections with antibiotic prophylaxis [82], a 60% reduction in episodes of influenza with the physical separation of the young and the elderly, [83] or a 48% reduction in episodes of pneumococcal pneumonia with the 23-valent vaccine [84].…”

Section: To What Extent Do You Think That Infection In the Elderly Ismentioning

confidence: 99%

The situation of infection in the elderly in Spain: a multidisciplinary opinion document

Bouza

Brenes²,

Domingo³

et al. 2020

Rev Esp Quimioter

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Infection in the elderly is a huge issue whose treatment usually has partial and specific approaches. It is, moreover, one of the areas where intervention can have the most success in improving the quality of life of older patients. In an attempt to give the widest possible focus to this issue, the Health Sciences Foundation has convened experts from different areas to produce this position paper on Infection in the Elderly, so as to compare the opinions of expert doctors and nurses, pharmacists, journalists, representatives of elderly associations and concluding with the ethical aspects raised by the issue. The format is that of discussion of a series of pre-formulated questions that were discussed by all those present. We begin by discussing the concept of the elderly, the reasons for their predisposition to infection, the most frequent infections and their causes, and the workload and economic burden they place on society. We also considered whether we had the data to estimate the proportion of these infections that could be reduced by specific programmes, including vaccination programmes. In this context, the limited presence of this issue in the media, the position of scientific societies and patient associations on the issue and the ethical aspects raised by all this were discussed.

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Section: To What Extent Do You Think That Infection In the Elderly Ismentioning

confidence: 99%

The situation of infection in the elderly in Spain: a multidisciplinary opinion document

Bouza

Brenes²,

Domingo³

et al. 2020

Rev Esp Quimioter

View full text Add to dashboard Cite

show abstract

“…Cálculo del tamaño muestral: Utilizando los datos aportados por estudios previos realizados en España enfocados en la incidencia de infecciones periprotésicas tras HA y asumiendo el peor escenario en nuestro medio, el cementado sin antibióticos tendría una tasa de infecciones esperables similar a la reportada por Aedo-Martín et al [8] (19%) y la disminución esperable, en el mejor de los escenarios, llegara a las cifras informadas por Sanz-Ruiz et al [6] con uso de cemento con antibióticos (2,3%), para una potencia del 80% con un intervalo de confianza al 95% el tamaño muestra requerido seria de 52 pacientes por brazo de tratamiento. Muestra y grupos: De la base de datos del servicio se identificaron los pacientes consecutivos tratados quirúrgicamente por fractura cervical de cadera mediante hemiartroplastia cementada de cadera entre febrero 2015 y febrero 2017.…”

Section: Materials Y Métodounclassified

“…. Habitualmente, se utiliza cemento impregnado con bajas dosis de antibiótico (0,5 g de antibiótico por cada 40 g de cemento) 6,7 , pero para algunos autores el cemento con alta dosis de antibiótico obtendría un mejor resultado en cuanto a la prevención de infección en hemiartroplastias (HA) 8 , sin embargo, existe poca evidencia que apoye esta última afirmación. Así, nuestro objetivo es estudiar si el uso de cemento con alta dosis de antibióticos es un factor asociado a una menor tasa de infección en hemiartroplastia de cadera tras fractura del cuello femoral.…”

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“…El cemento utilizado fue Palacos® R+G (Gentamicina 0,5g), no especifican la profilaxis antibiótica endovenosa utilizada, aunque parece no haber cambiado entre los dos periodos de estudio. Así mismo, Aedo-Martín et al [8] encontraron que el uso de cemento con antibióticos era un factor protector en el desarrollo de infección tardía en hemiartroplastia de cadera. En ese estudio el porcentaje de infecciones en HA cementadas posterior a fracturas del cuello femoral paso del 19% al 8%.…”

unclassified

“…En comparación con nosotros, la incidencia de infección periprotésica en sus dos periodos es bastante alta. Esta alta incidencia de infecciones (8,5% 6 y 19% [8] previo al uso de cemento con antibióticos) les ha permitido encontrar diferencias con significación estadística a favor de la cementación con antibióticos.…”

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Infección periprotésica en pacientes ancianos tratados mediante hemiartroplastia de cadera tras fractura intracapsular ¿Es el uso de cemento impregnado con altas dosis de antibiótico es un factor asociado a su disminución?.

Novoa-Parra¹,

Hurtado-Cerezo²,

Morales-Rodriguez³

et al. 2020

Rev Esp Cir Osteoart

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Objective: to study whether the use of cement with a high dose of antibiotics is a factor associated with a lower infection rate in hip hemiarthroplasty after femoral neck fracture.Material and methods: a retrospective cohort study of 144 consecutive patients treated surgically for a cervical hip fracture with cemented hip hemiarthroplasty between February 2015 and February 2017. In 88 (61.1%) high dose antibiotic cement was used, defined as a concentration ≥ 5% of the total weight (Group 1) and in 56 (38.9%) cement without antibiotics was used (Group 2). The primary outcome variable was periprosthetic infection.Results: there were 2 (1.38%) infections that were classified as deep, both in group 1. One of patients had a superficial infection in group 2. We did not find differences in the rate of infections between the two groups. Among the intra-surgical complications, we found two failures of the cement-prosthesis interface (non-adherence of the cement to the stem at the end of the setting time), both cases occurred in group 1. There was no allergic or toxic reaction. The mean survival time of all operated patients was 2.7 years (95% CI: 2.4-2.9) at the end of follow-up. We found no differences in survival when stratified by the use or not of antibiotics in cement, p = 0.874.Conclusion:In our experience, in patients undergoing hip hemiarthroplasties the use of cement with a high dose of antibiotic is not associated with lower infection rate when intravenous antibiotic prophylaxis is correct.

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Clinical Analysis of Surgical Treatment of Senile Intertrochanteric Fracture Based on Intelligent Knowledge of Health Care

Dong

et al. 2022

Contrast Media & Molecular Imaging

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In order to explore the clinical application value of intelligent health care knowledge combined with closed reduction intramedullary nail fixation in elderly patients with intertrochanteric fracture of the femur, a retrospective analysis is performed on 80 elderly patients who received intertrochanteric surgery from January 2019 to January 2021. All patients were divided into study group and control group based on intelligent medical knowledge received or not. During the phase of treatment, both the two groups were treated with closed reduction and intramedullary nailing. The control group received conventional knowledge training and rehabilitation before and after the surgery, and the research group received additional intelligent medical knowledge health care. Observations of patients after bed and ground time are compared and the VAS score is used to evaluate the pain degree at 12 h, 24 h, and 48 h after surgery. Besides, the incidence of postoperative complications in the two groups is observed. From the clinical follow-up results, it is clearly evident that intramedullary nail fixation based on medical care knowledge can effectively improve the hip function and quality of life in patients, reduce postoperative pain, and improve the prognosis of elderly patients with femoral trochanteric fracture.

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Infección periprótesica en pacientes ancianos tratados mediante hemiartroplastia de cadera tras fractura intracapsular. ¿Debemos usar cementación con antibiótico?

Cited by 4 publications

References 30 publications

The situation of infection in the elderly in Spain: a multidisciplinary opinion document

The situation of infection in the elderly in Spain: a multidisciplinary opinion document

Infección periprotésica en pacientes ancianos tratados mediante hemiartroplastia de cadera tras fractura intracapsular ¿Es el uso de cemento impregnado con altas dosis de antibiótico es un factor asociado a su disminución?.

Clinical Analysis of Surgical Treatment of Senile Intertrochanteric Fracture Based on Intelligent Knowledge of Health Care

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