Prosthetic Joint Infection Risk after TKA in the Medicare Population
Prosthetic Joint Infection Risk after TKA in the Medicare Population
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DOI：
10.1007/s11999-009-1013-5
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发表时间：
2010-01-01
影响因子：
4.2
通讯作者：
Parvizi, Javad
中科院分区：
文献类型：
--
作者：
Kurtz, Steven M.;Ong, Kevin L.;Parvizi, Javad
由于并发症的罕见性以及感染治疗和预防方面的暂时变化，目前当代全膝关节置换术（TKA）中的感染风险以及危险因素的相对重要性仍然存在争议。因此，我们确定了医疗保险人群 TKA 后的感染发生率和危险因素。 Medicare 5% 国家样本管理数据集用于识别和纵向跟踪 1997 年至 2006 年间接受 TKA 治疗深度感染和翻修手术的患者。Cox 回归用于评估患者和医院特征。在 69,663 名接受择期 TKA 的患者中，发现了 1400 例 TKA 感染。 2年内感染发生率为1.55%。 2年至10年的发病率为0.46%。女性感染的风险低于男性。合并症也增加了 TKA 感染风险。接受医疗保险保费公共援助的患者发生假体周围关节感染 (PJI) 的风险增加。医院因素并不能预测感染风险增加。医疗保险患者中 PJI 发生率相对较高，手术后 2 年内发生 PJI 的风险最大；然而，大约四分之一的 PJI 发生在 2 年后。
The current risk of infection in contemporary total knee arthroplasty (TKA) as well as the relative importance of risk factors remains under debate as a result of the rarity of the complication and temporal changes in the treatment and prevention of infection. We therefore determined infection incidence and risk factors after TKA in the Medicare population. The Medicare 5% national sample administrative data set was used to identify and longitudinally follow patients undergoing TKA for deep infections and revision surgery between 1997 and 2006. Cox regression was used to evaluate patient and hospital characteristics. In 69,663 patients undergoing elective TKA, 1400 TKA infections were identified. Infection incidence within 2 years was 1.55%. The incidence between 2 and up to 10 years was 0.46%. Women had a lower risk of infection than men. Comorbidities also increased TKA infection risk. Patients receiving public assistance for Medicare premiums were at increased risk for periprosthetic joint infection (PJI). Hospital factors did not predict an increased risk of infection. PJI occurs at a relatively high rate in Medicare patients with the greatest risk of PJI within the first 2 years after surgery; however, approximately one-fourth of all PJIs occur after 2 years.