Association of malnutrition with periprosthetic joint and surgical site infections after total joint arthroplasty: a systematic review and meta-analysis
A growing body of evidence associates malnutrition with several adverse outcomes. To investigate the link between malnutrition with surgical site and periprosthetic joint infections (SSIs and PJIs) following total knee and hip arthroplasty (TKA and THA) through a comprehensive meta-analysis of obser...
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| Veröffentlicht in: | The Journal of hospital infection 2019-09, Vol.103 (1), p.69-77 |
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| creator | Tsantes, A.G. Papadopoulos, D.V. Lytras, T. Tsantes, A.E. Mavrogenis, A.F. Korompilias, A.V. Gelalis, I.D. Tsantes, C.G. Bonovas, S. |
| description | A growing body of evidence associates malnutrition with several adverse outcomes.
To investigate the link between malnutrition with surgical site and periprosthetic joint infections (SSIs and PJIs) following total knee and hip arthroplasty (TKA and THA) through a comprehensive meta-analysis of observational studies.
A systematic search was conducted on PubMed and Scopus databases through December 2018, and recent proceedings of major orthopaedic meetings. Data from eligible studies were extracted and synthesized; pooled odds ratios (ORs) with 95% confidence intervals (CIs) were estimated.
Seven publications were included, reporting eight independent cohort studies with >250,000 subjects. SSIs and PJIs were more likely to develop in malnourished patients (OR: 2.49; 95% CI: 2.13–2.90; and 3.62; 2.33–5.64, respectively). The association of SSI with malnutrition was evident both after TKA (2.42; 1.94–3.02) and after THA (2.66; 1.64–4.30). Similarly, PJI was associated with malnutrition after TKA (2.55; 1.10–5.91) and after THA (3.10; 1.84–5.25). Finally, PJI correlated with malnutrition both after primary arthroplasty (3.58; 1.82–7.03) and revision arthroplasty (3.96; 2.47–6.33). The subgroup analysis by study setting confirmed the relationship between PJI and malnutrition in hospital (6.02; 3.07–11.81) and population-based (2.80; 1.76–4.44) studies.
Malnutrition is associated with PJIs and SSIs after total joint arthroplasty. Further high-quality research is warranted to confirm or refute these findings. |
| doi_str_mv | 10.1016/j.jhin.2019.04.020 |
| format | Article |
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To investigate the link between malnutrition with surgical site and periprosthetic joint infections (SSIs and PJIs) following total knee and hip arthroplasty (TKA and THA) through a comprehensive meta-analysis of observational studies.
A systematic search was conducted on PubMed and Scopus databases through December 2018, and recent proceedings of major orthopaedic meetings. Data from eligible studies were extracted and synthesized; pooled odds ratios (ORs) with 95% confidence intervals (CIs) were estimated.
Seven publications were included, reporting eight independent cohort studies with >250,000 subjects. SSIs and PJIs were more likely to develop in malnourished patients (OR: 2.49; 95% CI: 2.13–2.90; and 3.62; 2.33–5.64, respectively). The association of SSI with malnutrition was evident both after TKA (2.42; 1.94–3.02) and after THA (2.66; 1.64–4.30). Similarly, PJI was associated with malnutrition after TKA (2.55; 1.10–5.91) and after THA (3.10; 1.84–5.25). Finally, PJI correlated with malnutrition both after primary arthroplasty (3.58; 1.82–7.03) and revision arthroplasty (3.96; 2.47–6.33). The subgroup analysis by study setting confirmed the relationship between PJI and malnutrition in hospital (6.02; 3.07–11.81) and population-based (2.80; 1.76–4.44) studies.
Malnutrition is associated with PJIs and SSIs after total joint arthroplasty. Further high-quality research is warranted to confirm or refute these findings.</description><identifier>ISSN: 0195-6701</identifier><identifier>EISSN: 1532-2939</identifier><identifier>DOI: 10.1016/j.jhin.2019.04.020</identifier><identifier>PMID: 31054936</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Aged ; Arthritis - epidemiology ; Arthroplasty, Replacement, Hip - adverse effects ; Arthroplasty, Replacement, Knee - adverse effects ; Cohort Studies ; Female ; Humans ; Male ; Malnutrition ; Malnutrition - complications ; Middle Aged ; Periprosthetic joint infection ; Prosthesis-Related Infections - epidemiology ; Surgical site infection ; Surgical Wound Infection - epidemiology ; Total hip arthroplasty ; Total knee arthroplasty</subject><ispartof>The Journal of hospital infection, 2019-09, Vol.103 (1), p.69-77</ispartof><rights>2019 The Healthcare Infection Society</rights><rights>Copyright © 2019 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c405t-c9755c6cb6f14dfb96bcbcd3b9e25433b77bd3a1dcf496896b89624c69831dba3</citedby><cites>FETCH-LOGICAL-c405t-c9755c6cb6f14dfb96bcbcd3b9e25433b77bd3a1dcf496896b89624c69831dba3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0195670119301896$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31054936$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tsantes, A.G.</creatorcontrib><creatorcontrib>Papadopoulos, D.V.</creatorcontrib><creatorcontrib>Lytras, T.</creatorcontrib><creatorcontrib>Tsantes, A.E.</creatorcontrib><creatorcontrib>Mavrogenis, A.F.</creatorcontrib><creatorcontrib>Korompilias, A.V.</creatorcontrib><creatorcontrib>Gelalis, I.D.</creatorcontrib><creatorcontrib>Tsantes, C.G.</creatorcontrib><creatorcontrib>Bonovas, S.</creatorcontrib><title>Association of malnutrition with periprosthetic joint and surgical site infections after total joint arthroplasty: a systematic review and meta-analysis</title><title>The Journal of hospital infection</title><addtitle>J Hosp Infect</addtitle><description>A growing body of evidence associates malnutrition with several adverse outcomes.
To investigate the link between malnutrition with surgical site and periprosthetic joint infections (SSIs and PJIs) following total knee and hip arthroplasty (TKA and THA) through a comprehensive meta-analysis of observational studies.
A systematic search was conducted on PubMed and Scopus databases through December 2018, and recent proceedings of major orthopaedic meetings. Data from eligible studies were extracted and synthesized; pooled odds ratios (ORs) with 95% confidence intervals (CIs) were estimated.
Seven publications were included, reporting eight independent cohort studies with >250,000 subjects. SSIs and PJIs were more likely to develop in malnourished patients (OR: 2.49; 95% CI: 2.13–2.90; and 3.62; 2.33–5.64, respectively). The association of SSI with malnutrition was evident both after TKA (2.42; 1.94–3.02) and after THA (2.66; 1.64–4.30). Similarly, PJI was associated with malnutrition after TKA (2.55; 1.10–5.91) and after THA (3.10; 1.84–5.25). Finally, PJI correlated with malnutrition both after primary arthroplasty (3.58; 1.82–7.03) and revision arthroplasty (3.96; 2.47–6.33). The subgroup analysis by study setting confirmed the relationship between PJI and malnutrition in hospital (6.02; 3.07–11.81) and population-based (2.80; 1.76–4.44) studies.
Malnutrition is associated with PJIs and SSIs after total joint arthroplasty. Further high-quality research is warranted to confirm or refute these findings.</description><subject>Aged</subject><subject>Arthritis - epidemiology</subject><subject>Arthroplasty, Replacement, Hip - adverse effects</subject><subject>Arthroplasty, Replacement, Knee - adverse effects</subject><subject>Cohort Studies</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Malnutrition</subject><subject>Malnutrition - complications</subject><subject>Middle Aged</subject><subject>Periprosthetic joint infection</subject><subject>Prosthesis-Related Infections - epidemiology</subject><subject>Surgical site infection</subject><subject>Surgical Wound Infection - epidemiology</subject><subject>Total hip arthroplasty</subject><subject>Total knee arthroplasty</subject><issn>0195-6701</issn><issn>1532-2939</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UcmO1DAQtRCIaQZ-gAPykUuClzhpIy6jEZs0Ehc4W45ToSvK0rgcRv0nfO440w1HDiWr_Bap3mPstRSlFLJ-N5TDAedSCWlLUZVCiSdsJ41WhbLaPmW7DJiiboS8Yi-IBiFE_jfP2ZWWwlRW1zv254ZoCegTLjNfej75cV5TxMf9HtOBHyHiMS6UDpAw8GHBOXE_d5zW-BODHzlhAo5zD2FTEfd9gsjTkjJ2ocd0iMtx9JRO77nndKIEk9_8IvxGuH80nCD5ws9-PBHSS_as9yPBq8t7zX58-vj99ktx9-3z19ubuyJUwqQi2MaYUIe27mXV9a2t29CGTrcWlKm0bpum7bSXXegrW-8znEdVobZ7LbvW62v29uybb_y1AiU3IQUYRz_DspJTSisppdk3marO1JDjoAi9O0acfDw5KdzWiBvc1ojbGnGicrmRLHpz8V_bCbp_kr8VZMKHMwHylTmL6CggzAE6jDlR1y34P_8HbX6h-A</recordid><startdate>201909</startdate><enddate>201909</enddate><creator>Tsantes, A.G.</creator><creator>Papadopoulos, D.V.</creator><creator>Lytras, T.</creator><creator>Tsantes, A.E.</creator><creator>Mavrogenis, A.F.</creator><creator>Korompilias, A.V.</creator><creator>Gelalis, I.D.</creator><creator>Tsantes, C.G.</creator><creator>Bonovas, S.</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201909</creationdate><title>Association of malnutrition with periprosthetic joint and surgical site infections after total joint arthroplasty: a systematic review and meta-analysis</title><author>Tsantes, A.G. ; Papadopoulos, D.V. ; Lytras, T. ; Tsantes, A.E. ; Mavrogenis, A.F. ; Korompilias, A.V. ; Gelalis, I.D. ; Tsantes, C.G. ; Bonovas, S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c405t-c9755c6cb6f14dfb96bcbcd3b9e25433b77bd3a1dcf496896b89624c69831dba3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Aged</topic><topic>Arthritis - epidemiology</topic><topic>Arthroplasty, Replacement, Hip - adverse effects</topic><topic>Arthroplasty, Replacement, Knee - adverse effects</topic><topic>Cohort Studies</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Malnutrition</topic><topic>Malnutrition - complications</topic><topic>Middle Aged</topic><topic>Periprosthetic joint infection</topic><topic>Prosthesis-Related Infections - epidemiology</topic><topic>Surgical site infection</topic><topic>Surgical Wound Infection - epidemiology</topic><topic>Total hip arthroplasty</topic><topic>Total knee arthroplasty</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tsantes, A.G.</creatorcontrib><creatorcontrib>Papadopoulos, D.V.</creatorcontrib><creatorcontrib>Lytras, T.</creatorcontrib><creatorcontrib>Tsantes, A.E.</creatorcontrib><creatorcontrib>Mavrogenis, A.F.</creatorcontrib><creatorcontrib>Korompilias, A.V.</creatorcontrib><creatorcontrib>Gelalis, I.D.</creatorcontrib><creatorcontrib>Tsantes, C.G.</creatorcontrib><creatorcontrib>Bonovas, S.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of hospital infection</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tsantes, A.G.</au><au>Papadopoulos, D.V.</au><au>Lytras, T.</au><au>Tsantes, A.E.</au><au>Mavrogenis, A.F.</au><au>Korompilias, A.V.</au><au>Gelalis, I.D.</au><au>Tsantes, C.G.</au><au>Bonovas, S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association of malnutrition with periprosthetic joint and surgical site infections after total joint arthroplasty: a systematic review and meta-analysis</atitle><jtitle>The Journal of hospital infection</jtitle><addtitle>J Hosp Infect</addtitle><date>2019-09</date><risdate>2019</risdate><volume>103</volume><issue>1</issue><spage>69</spage><epage>77</epage><pages>69-77</pages><issn>0195-6701</issn><eissn>1532-2939</eissn><abstract>A growing body of evidence associates malnutrition with several adverse outcomes.
To investigate the link between malnutrition with surgical site and periprosthetic joint infections (SSIs and PJIs) following total knee and hip arthroplasty (TKA and THA) through a comprehensive meta-analysis of observational studies.
A systematic search was conducted on PubMed and Scopus databases through December 2018, and recent proceedings of major orthopaedic meetings. Data from eligible studies were extracted and synthesized; pooled odds ratios (ORs) with 95% confidence intervals (CIs) were estimated.
Seven publications were included, reporting eight independent cohort studies with >250,000 subjects. SSIs and PJIs were more likely to develop in malnourished patients (OR: 2.49; 95% CI: 2.13–2.90; and 3.62; 2.33–5.64, respectively). The association of SSI with malnutrition was evident both after TKA (2.42; 1.94–3.02) and after THA (2.66; 1.64–4.30). Similarly, PJI was associated with malnutrition after TKA (2.55; 1.10–5.91) and after THA (3.10; 1.84–5.25). Finally, PJI correlated with malnutrition both after primary arthroplasty (3.58; 1.82–7.03) and revision arthroplasty (3.96; 2.47–6.33). The subgroup analysis by study setting confirmed the relationship between PJI and malnutrition in hospital (6.02; 3.07–11.81) and population-based (2.80; 1.76–4.44) studies.
Malnutrition is associated with PJIs and SSIs after total joint arthroplasty. Further high-quality research is warranted to confirm or refute these findings.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>31054936</pmid><doi>10.1016/j.jhin.2019.04.020</doi><tpages>9</tpages></addata></record> |
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| subjects | Aged Arthritis - epidemiology Arthroplasty, Replacement, Hip - adverse effects Arthroplasty, Replacement, Knee - adverse effects Cohort Studies Female Humans Male Malnutrition Malnutrition - complications Middle Aged Periprosthetic joint infection Prosthesis-Related Infections - epidemiology Surgical site infection Surgical Wound Infection - epidemiology Total hip arthroplasty Total knee arthroplasty |
| title | Association of malnutrition with periprosthetic joint and surgical site infections after total joint arthroplasty: a systematic review and meta-analysis |
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