Preoperative Risk Factors for Postoperative Urinary Tract Infection After Primary Total Hip and Knee Arthroplasties

Nguyen, Austin Q.; Foy, Michael; Sood, Anshum; Gonzalez, Mark H.

doi:10.1016/j.arth.2020.08.002

Cited by 13 publications

(12 citation statements)

References 33 publications

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“…An increased rate of urinary tract infection following major orthopedic surgery has also been reported. 32 Other adverse events that can occur after perioperative transfusion include transfusion-associated circulatory overload, hemolytic reactions, allergic reactions, transfusion-related infection and transfusion-related lung injury. 33 , 34 Storage of red blood cell for more than 2 weeks has been found to be related to a high risk of in-hospital mortality and postoperative complications.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Correction of Low Hemoglobin Levels Can Reduce 1-Year All-Cause Mortality in Osteoporotic Hip Fracture Patients: A Retrospective Observational Study

Manosroi¹,

Atthakomol²,

Isaradech³

et al. 2022

CIA

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Purpose Osteoporotic hip fracture surgery is associated with a risk of morbidity and mortality. Admission hemoglobin levels <10 g/dL have been documented as a strong predictor of mortality risk. This study aimed to investigate the mortality outcome between osteoporotic hip fracture patients who had preoperative hemoglobin levels raised to ≥10 g/dL and those with hemoglobin levels were <10 g/dL. Patients and Methods This 5-year retrospective observational study included 226 participants with osteoporotic hip fractures that required surgery and who had admission hemoglobin levels <10 g/dL. Patients were categorized into two groups: those with corrected preoperative hemoglobin ≥10 g/dL and those with either corrected or uncorrected preoperative hemoglobin <10 g/dL. Outcomes were analyzed using Cox proportional hazard regression adjusted for confounders. Results are presented as hazard ratio (HR) and 95% confidence interval (95% CI). Results Among 226 the patients, the overall mortality rate was 17.25% (n=39/226) of the 226 patients, 93 (41.15%) had their hemoglobin levels raised to ≥10 g/dL by red blood cell transfusion. Multivariable analysis after adjustment for confounders showed a 50% lower incidence of mortality among patients with preoperative hemoglobin levels ≥10 g/dL than among those with hemoglobin levels <10 g/dL (HR 0.50, 95% CI (0.25–0.99), p=0.048). Conclusion In osteoporotic hip fracture patients with admission hemoglobin <10g/dL, raising preoperative hemoglobin levels to ≥10 g/dL can significantly reduce the risk of mortality. Testing for and correction of low preoperative hemoglobin levels is of value in hip surgery patients.

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Section: Discussionmentioning

confidence: 99%

Preoperative Correction of Low Hemoglobin Levels Can Reduce 1-Year All-Cause Mortality in Osteoporotic Hip Fracture Patients: A Retrospective Observational Study

Manosroi¹,

Atthakomol²,

Isaradech³

et al. 2022

CIA

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“…e longer the operation time means that the patient's wound is exposed to the air for a longer time, and the more external bacteria and microorganisms invade, so postoperative infection is more likely to occur [19]. However, the excessive number of combined underlying diseases indicates that the patient's own internal environment is disorganized and the anti-infection ability is low, so the body's immune system is not sensitive to external microbial invasion, and it is more likely to cause postoperative infection [20]. Compared with patients undergoing elective surgery, emergency patients do not have enough time to prepare for preoperative disinfection and are rushed to clean the wound, so the number of pathogen invasion will be significantly higher than that of patients with surgical preparation, so the postoperative infection rate will increase [21].…”

Section: Related Workmentioning

confidence: 99%

Analysis of Expression of Inflammatory Factors and T Cell Lymphocyte in Patients with Orthopedic Trauma after Infection and Risk Factors

Lin

Chen

Zhang

2022

Contrast Media & Molecular Imaging

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Since most orthopedic patients’ wounds are open in clinical practice, postoperative wound infection and other conditions are prone to occur, which pose varying degrees of threat to patients’ prognosis and life and health. In this paper, a retrospective study is conducted on orthopedic trauma patients in our hospital from January 2020 to January 2022, including 98 patients with postoperative infection and 98 patients without infection, to detect and compare the levels of inflammatory factors and the level of T cell lymphatic group index difference. The ROC curve is drawn to analyze the diagnostic efficacy of postoperative infection indicators for patients with orthopedic trauma. The differences in baseline data between the two groups are compared. Multivariate Logistic regression analysis is performed on infection status. The experimental results show that the IL-6, IL-2, and CRP of the infection group of patients are significantly higher than uninfected group, and the CD3, CD4, and CD8 are significantly lower than uninfected group, which means that patients with infection after orthopedic trauma are in a disordered state of immune cytokines and function. Therefore, postoperative infection can be effectively assessed by early combined detection of the above indicators. In addition, the analysis of other clinical data showed that the operation time, the number of underlying diseases, and the surgical method are also risk factors for postoperative infection.

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“…Increased age 11,21-23 has been strongly associated with VTE events. Older age also is a risk factor for CA-UTIs 24,25 , which may be explained by decreased bladder function as patients age (Table I).…”

Section: Tka and Thamentioning

confidence: 99%

“…Preoperative Steroid Use: Preoperative steroid use may be associated with a greater risk of CA-UTIs 24,25 . This correlates with the previous findings that steroid use is associated with the incidence of any HAC when undergoing TKA or THA 12,33 .…”

Section: Tka and Thamentioning

confidence: 99%

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Hospital-Acquired Conditions

et al. 2021

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In 2016, a total of 48,771 hospital-acquired conditions (HACs) were reported in U.S. hospitals. These incidents resulted in an excess cost of .$2 billion, which translates to roughly $41,000 per patient per HAC. » In the settings of total hip arthroplasty (THA) and total knee arthroplasty (TKA), increased age, a body mass index of .35 kg/m 2 , male sex, diabetes mellitus, electrolyte disturbances, and a history of anemia increase the likelihood of surgical site infections.Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSREV/A722).

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Preoperative Risk Factors for Postoperative Urinary Tract Infection After Primary Total Hip and Knee Arthroplasties

Cited by 13 publications

References 33 publications

Preoperative Correction of Low Hemoglobin Levels Can Reduce 1-Year All-Cause Mortality in Osteoporotic Hip Fracture Patients: A Retrospective Observational Study

Preoperative Correction of Low Hemoglobin Levels Can Reduce 1-Year All-Cause Mortality in Osteoporotic Hip Fracture Patients: A Retrospective Observational Study

Analysis of Expression of Inflammatory Factors and T Cell Lymphocyte in Patients with Orthopedic Trauma after Infection and Risk Factors

Hospital-Acquired Conditions

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