Surgical Site Infection After Primary Hip and Knee Arthroplasty: A Cohort Study Using a Hospital Database

Grammatico‐Guillon, Leslie; Baron, S.; Rosset, Philippe; Gaborit, Christophe; Bernard, Louis; Rüsch, Emmanuel; Astagneau, Pascal

doi:10.1017/ice.2015.148

Cited by 48 publications

(55 citation statements)

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“…First, the use of administrative hospital databases introduced an inherent bias that should be taken into consideration. Strengths and limitations of using healthcare databases for epidemiological purposes have already been extensively discussed [ 27 – 31 ]. Briefly, the PMSI (the national hospital healthcare database used here) was initially designed for billing purposes but now appears to be a powerful tool for epidemiological surveillance.…”

Section: Discussionmentioning

confidence: 99%

Ten-year trends in intensive care admissions for respiratory infections in the elderly

Laporte

Hermetet

Jouan

et al. 2018

Ann. Intensive Care

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BackgroundThe consequences of the ageing population concerning ICU hospitalisation need to be adequately described. We believe that this discussion should be disease specific. A focus on respiratory infections is of particular interest, because it is strongly associated with old age. Our objective was to assess trends in demographics over a decade among elderly patients admitted to the ICU for acute respiratory infections.MethodsA cross-sectional study was performed between 2006 and 2015 based on hospital discharge databases in one French region (2.5 million inhabitants). Patients with acute respiratory infection were selected according to the specific ICD-10 diagnosis codes recorded, including acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and community-acquired pneumonia (CAP). We also identified comorbid conditions based on any significant ICD-10 secondary diagnoses adapted from the Charlson and Elixhauser indexes.ResultsA total of 98,381 hospital stays for acute respiratory infection were identified among the 3,856,785 stays over the 10-year period. The number of patients 75 y/o and younger increased 1.6-fold from 2006 to 2015, whereas the numbers of patients aged 85–89 and ≥ 90 y/o increased by 2.5- and 2.1-fold, respectively. Both CAP and AECOPD hospitalisations significantly increased for all age groups over the decade. ICU hospitalisations for respiratory infection increased 2.7-fold from 2006 to 2015 (p = 0.0002). The greatest increases in the use of ICU resources were for the 85–89 and ≥ 90 y/o groups, which corresponded to increases of 3.3- and 5.8-fold. Indeed, the proportion of patients hospitalized for respiratory infection in ICU that were elderly clearly grew during the decade: 11.3% were ≥ 85 y/o in 2006 versus 16.4% in 2015 (p < 0.0001). This increase in ICU hospitalisation rate of ageing patients was not associated with significant changes in the level of care or ICU mortality except for patients ≥ 90 y/o (for whom ICU mortality dropped from 40.9 to 22.3%, p = 0.03).ConclusionWe observed a substantial increase in acute respiratory infection diagnoses associated with hospitalisation between 2006 and 2015, with a growing demand for critical care services. Both the absolute number and the percentage of elderly patient ICU admissions increased over the last decade, with the greatest increases being observed for patients 85 years and older.Electronic supplementary materialThe online version of this article (10.1186/s13613-018-0430-6) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Ten-year trends in intensive care admissions for respiratory infections in the elderly

Laporte

Hermetet

Jouan

et al. 2018

Ann. Intensive Care

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“…Nevertheless, the incidence of PJI and the micro-organisms that were isolated were similar to those found in other studies 1,4,34,35 . Finally, although we could adjust for a number of known risk factors through linkage with other registers, there were a number of risk factors not recorded in the registers; e.g., weight/body mass index 36 , smoking 37 , and alcohol consumption 38 . These variables represent individual risk factors and they are only accounted for if the comorbidity is implemented in the Charlson comorbidity index.…”

Section: Discussionmentioning

confidence: 99%

One-year incidence of prosthetic joint infection in total hip arthroplasty: a cohort study with linkage of the Danish Hip Arthroplasty Register and Danish Microbiology Databases

Gundtoft

Pedersen

Schønheyder

et al. 2017

Osteoarthritis and Cartilage

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“…A population-based cohort of patients having primary THA was identified by the hospitals’ procedure claims and medical devices reimbursed; this method has been used and validated [20, 21]. The eligible population was all patients 40 years or older, having undergone unilateral primary THA between January 1, 2009, and December 31, 2012 (48 months).…”

Section: Methodsmentioning

confidence: 99%

Exchangeable Femoral Neck (Dual-Modular) THA Prostheses Have Poorer Survivorship Than Other Designs: A Nationwide Cohort of 324,108 Patients

Colas

Allalou

Poichotte

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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BackgroundExchangeable neck stems, defined as those with a dual taper (that is, a modular junction between the femoral head and the femoral neck and an additional junction between the neck and the stem body), were introduced in THA to improve restoration of joint biomechanics (restoring anteversion, offset, and limb length) and reduce the risk of dislocation. However exchangeable necks have been reported to result in adverse effects such as stem fractures and acute local tissue reaction. Whether they result in a net improvement to or impairment of reconstructive survivorship remains controversial.Questions/Purposes(1) To compare the prosthetic survivorship and all-cause revision risk of exchangeable femoral neck THAs versus fixed neck THAs, taking known prosthetic revision risk factors into account; and (2) to compare the cause-specific revision risk of exchangeable femoral neck THAs versus fixed neck THAs, adjusting for known prosthetic risk factors.MethodsUsing French national health-insurance databases, we identified all French patients older than 40 years who underwent primary THA from 2009 through 2012. To ensure accuracy of the data, we considered only beneficiaries of the general insurance scheme (approximately 77% of the population). Characteristics of the prosthesis and the patients receiving an exchangeable femoral neck THA were compared with those receiving a fixed femoral neck THA (defined as femoral stem with only the head being exchangeable). Revision was the event of interest. Followup started on the date the THA was performed, until the patient experienced revision, died, was lost to followup, or until the followup period ended (December 31, 2014), whichever came first. Competing risk THA survivorship was calculated and compared (purpose 1), as were cause-specific Cox regression models (purpose 2). The study cohort included 324,108 individuals with a mean age of 77 years. A total of 24% underwent THA for acute trauma, and 3% of the group received an exchangeable neck THA. During the median 45-month followup (mean, 42 months; minimum, 1 day; maximum, 6 years), 11,968 individuals underwent prosthetic revision.ResultsThe cumulative revision incidence was 6.5% (95% CI, 5.8%–7.3%) for exchangeable neck THAs versus 4.7% (95% CI, 4.6%–4.8%) for fixed neck THAs (p < 0.001). After controlling for potential confounding variables including age, sex, comorbidities, indication for THA, cementation, bearing surface, and the characteristics of the center where the implantation was performed, we found that the exchangeable femoral neck THA was associated with an increased hazard ratio (HR) of revision of 1.26 (95% CI, 1.14–1.38; p < 0.001) compared with the fixed neck THA. When dealing with cause-specific revision, exchangeable neck THAs had a higher incidence of revision for implant failure or periprosthetic fracture, and for mechanical complications; adjusted HRs were, respectively, 1.68 (95% CI, 1.24–2.27; p < 0.001) and 1.27 (95% CI, 1.13–1.43; p < 0.001), for exchangeable neck THAs compared with fixed ones.C...

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Surgical Site Infection After Primary Hip and Knee Arthroplasty: A Cohort Study Using a Hospital Database

Abstract: The hospital database method used to measure occurrence and risk factors of prosthetic joint infection helped to survey HKAI and could optimize healthcare delivery.

Cited by 48 publications

References 39 publications

Ten-year trends in intensive care admissions for respiratory infections in the elderly

Ten-year trends in intensive care admissions for respiratory infections in the elderly

One-year incidence of prosthetic joint infection in total hip arthroplasty: a cohort study with linkage of the Danish Hip Arthroplasty Register and Danish Microbiology Databases

Exchangeable Femoral Neck (Dual-Modular) THA Prostheses Have Poorer Survivorship Than Other Designs: A Nationwide Cohort of 324,108 Patients

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