Infection Burden for Hip and Knee Arthroplasty in the United States

Kurtz, Steven M.; Lau, Edmund; Schmier, Jordana K.; Ong, Kevin; Zhao, Ke; Parvızı, Javad

doi:10.1016/j.arth.2007.10.017

Cited by 865 publications

(606 citation statements)

References 13 publications

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“…Finally, like many past studies, we used hospital charges to estimate costs for treating SSIs. 14,15,23,24 However, hospital charges are usually overestimates of the actual costs to the hospital for the services provided during treatment. We attempted to offset this limitation by using a matched case-control method so that the difference in charge to cost ratio was partially accounted for.…”

Section: Discussionmentioning

confidence: 99%

“…We attempted to offset this limitation by using a matched case-control method so that the difference in charge to cost ratio was partially accounted for. 24 This study is the first to provide a comprehensive analysis of the major costs and risk factors for SSIs across orthopedic trauma patients. In the current reimbursement model, hospitals and physicians are compensated for additional treatment required for infections.…”

Section: Discussionmentioning

confidence: 99%

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Surgical site infection in orthopedic trauma: A case–control study evaluating risk factors and cost

Thakore

Greenberg

Shi

et al. 2015

Journal of Clinical Orthopaedics and Trauma

125

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a b s t r a c tBackground: With the shift of our healthcare system toward a value-based system of reimbursement, complications such as surgical site infections (SSI) may not be reimbursed.The purpose of our study was to investigate the costs and risk factors of SSI for orthopedic trauma patients.Methods: Through retrospective analysis, 1819 patients with isolated fractures were identified. Of those, 78 patients who developed SSIs were compared to 78 uninfected control patients. Patients were matched by fracture location, type of fracture, duration of surgery, and as close as possible to age, year of surgery, and type of procedure. Costs for treatment during primary hospitalization and initial readmission were determined and potential risk factors were collected from patient charts. A Wilcoxon test was used to compare the overall costs of treatment for case and control patients. Costs were further broken down into professional fees and technical charges for analysis. Risk factors for SSIs were analyzed through a chi-squared analysis.Results: Median cost for treatment for patients with SSIs was $108,782 compared to $57,418 for uninfected patients ( p < 0.001). Professional fees and technical charges were found to be significantly higher for infected patients. No significant risk factors for SSIs were determined.Conclusions: Our findings indicate the potential for financial losses in our new healthcare system due to uncompensated care. SSIs nearly double the cost of treatment for orthopedic trauma patients. There is no single driver of these costs. Reducing postoperative stay may be one method for reducing the cost of treating SSIs, whereas quality management programs may decrease risk of infection.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Surgical site infection in orthopedic trauma: A case–control study evaluating risk factors and cost

Thakore

Greenberg

Shi

et al. 2015

Journal of Clinical Orthopaedics and Trauma

125

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“…Infection has occurred in approximately 1% to 2% of primary TKA surgeries and has been the leading cause of failure following TKA [33,34,40,50]. Surgeons have used various methods in the initial treatment of periprosthetic knee infection, including irrigation and débridement, direct exchange arthroplasty, and two-stage revision arthroplasty with subsequent reimplantation.…”

Section: Discussionmentioning

confidence: 99%

“…Infection has occurred in 1% to 2% of primary TKA surgeries and has been the leading cause of failure following TKA [33,34,40,50]. The rate of periprosthetic infection has been declining over the last two to three decades, mostly due to operating room environments and operative techniques [17,27,40].…”

Section: Introductionmentioning

confidence: 99%

Assessing the Gold Standard: A Review of 253 Two-Stage Revisions for Infected TKA

Mahmud

Lyons

Naudie

et al. 2012

Clinical Orthopaedics &Amp; Related Research

119

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Background Periprosthetic joint infection has been the leading cause of failure following TKA surgery. The gold standard for infection control has been a two-staged revision TKA. There have been few reports on mid-to longterm survivorship, functional outcomes, and fate of patients with a failed two-stage revision TKA. Questions/purposes Therefore, we determined (1) the mid-term survivorship of two-stage revision TKA, (2) the function of patients in whom infection was controlled, and (3) the outcome of patients with a failed two-stage revision due to recurrent infection. Methods We retrospectively reviewed 239 patients who underwent 253 two-stage revision TKAs for periprosthetic infection. There were 239 patients (253 knees), 104 men and 135 women, with a mean age of 70 ± 10 years at the time of two-stage revision and a mean BMI of 31.53 ± 6.74 kg/m 2 . During followup, we obtained WOMAC and The Knee Society Clinical Rating Scores and radiographs.

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“…Infection is currently the most frequently reported reason for revision in TKA [3]. Recent epidemiologic studies using the Nationwide Inpatient Sample suggest both the incidence and prevalence of PJI may be increasing over time in the United States [10,11]. The reasons underlying these temporal trends in infection have not yet been fully elucidated.…”

Section: Introductionmentioning

confidence: 99%