Obese Diabetic Patients are at Substantial Risk for Deep Infection after Primary TKA
Obese Diabetic Patients are at Substantial Risk for Deep Infection after Primary TKA
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DOI：
10.1007/s11999-008-0551-6
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发表时间：
2009-06-01
影响因子：
4.2
通讯作者：
Choong, Peter F. M.
中科院分区：
文献类型：
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作者：
Dowsey, Michelle M.;Choong, Peter F. M.
我们对1214例连续初次TKA患者进行了一项前瞻性研究，以比较术后前12个月内肥胖和非肥胖患者的假体深部感染率。我们还试图确定患者或手术变量（例如合并症、年龄、性别、输血、手术引流管的使用和抗生素浸渍骨水泥）是否是初次全膝关节置换术后后续假体感染的预测因素。总假体感染率为1.5%（n = 18）。病态肥胖（OR，8.96; 95%置信区间，1.59-50.63）和糖尿病（OR，6.87; 95%置信区间，2.42-19.56）患者的假体深部感染几率更大。男性比女性更容易发生假体感染（OR，5.93; 95%置信区间，1.95-18.04），使用外科引流管的患者的假体感染率较低（OR，0.24; 95%置信区间，0.06-0.95）。在不肥胖的糖尿病患者中没有假体感染。相比之下，肥胖和糖尿病患者有11例假体感染，肥胖但非糖尿病患者有4例假体感染。病态肥胖和肥胖合并糖尿病是TKA术后假体周围感染的危险因素。证据等级：II级，预后研究。有关证据等级的完整描述，请参见作者指南。
We conducted a prospective study of 1214 consecutive primary TKAs to compare the deep prosthetic infection rate between obese and nonobese patients during the first 12 months after surgery. We also sought to determine whether patient or surgical variables such as comorbidities, age, gender, blood transfusion, use of surgical drains, and antibiotic-impregnated cement were predictors of subsequent prosthetic infection after primary TKA. The overall prosthetic infection rate was 1.5% (n = 18). The odds for a deep prosthetic infection were greater in patients with morbid obesity (odds ratio [OR], 8.96; 95% confidence interval, 1.59-50.63) and diabetes (OR, 6.87; 95% confidence interval, 2.42-19.56). Men were more likely to have a prosthetic infection develop than women (OR, 5.93; 95% confidence interval, 1.95-18.04) and the prosthetic infection rate was lower (OR, 0.24; 95% confidence interval, 0.06-0.95) in patients when a surgical drain was used. There were no prosthetic infections in patients with diabetes who were not obese. This compares with 11 prosthetic infections in patients who were obese and diabetic and four prosthetic infections in patients who were obese but not diabetic. Morbid obesity and obesity combined with diabetes are risk factors for periprosthetic infection after TKA.Level of Evidence: Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.