Risk factors and outcome of patients with periprosthetic joint infection admitted to intensive care unit
Introduction Prosthetic joint infection (PJI) is a severe complication after total joint replacement surgery. The current study analyzes the outcome and mortality of patients admitted to an intensive care unit following PJI. Methods Retrospective analysis of all patients treated between 2012 and 201...
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| Veröffentlicht in: | Archives of orthopaedic and trauma surgery 2020-08, Vol.140 (8), p.1081-1085 |
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| description | Introduction
Prosthetic joint infection (PJI) is a severe complication after total joint replacement surgery. The current study analyzes the outcome and mortality of patients admitted to an intensive care unit following PJI.
Methods
Retrospective analysis of all patients treated between 2012 and 2016 due to PJI in the surgical intensive care unit of a university hospital.
Results
A total of 124 patients were included. The mean age was 75 ± 11 years. Of those 124 patients, 85 patients (68.5%) suffered a prosthetic infection of the hip, 33 patients (27.3%) of the knee, six patients (4.8%) of hip and knee. 52 patients were male (40.9%). The assessed mean Simplified Acute Physiology Score II (SAPSII) was 29.6 ± 5.9. The mortality rate was 21% (26/124). Of surviving patients, 53.1% were discharged home, 25.5% were transferred to a nursing home, and 21.4% were transferred to a geriatric rehabilitation center. Comparing survivors to non-survivors, the non-survivor group showed a higher incidence of renal replacement therapy (46.1 vs 3.0%;
p
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| doi_str_mv | 10.1007/s00402-020-03471-x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2401124439</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2401124439</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-71a1e5c3fd7c389fa3e2eb8deeb8a3d1d9e1b2215f1780f0968a01a6976d40c73</originalsourceid><addsrcrecordid>eNp9kU9PVDEUxRsjkQH8Ai5MEzduHt7-mfdel4aomJCQGFg3nfbW6TivHds-hG9PYRATF2zapPd3zz29h5B3DE4ZwPCpAEjgHXDoQMiBdbevyIJJITuhWP-aLECJvhthyQ7JUSkbAMZHBW_IoeBiHHupFmT9I5Rf1BtbUy7UREfTXG2akCZPd6YGjLXQP6Gu6Q5z2OVU6hprsHSTQqw0RI-2hhSpcVOoFR2tqb1WjCXcILUmI51jqCfkwJttwbdP9zG5_vrl6uy8u7j89v3s80VnxbCs3cAMw6UV3g1WjMobgRxXo8N2GOGYU8hWnLOlZ8MIHlQ_GmCmV0PvJNhBHJOPe91m9feMpeopFIvbrYmY5qK5BMa4lEI19MN_6CbNOTZ3jeL8YVvQN4rvKdv-XjJ6vcthMvlOM9APOeh9DrrloB9z0Let6f2T9Lya0D23_F18A8QeKK0Uf2L-N_sF2XsIs5Tj</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2422012806</pqid></control><display><type>article</type><title>Risk factors and outcome of patients with periprosthetic joint infection admitted to intensive care unit</title><source>Springer Nature - Complete Springer Journals</source><creator>Pöll, Alexandra Margarete ; Baecker, Hinnerk ; Yilmaz, Emre ; Jansen, Oliver ; Waydhas, Christian ; Schildhauer, Thomas Armin ; Hamsen, Uwe</creator><creatorcontrib>Pöll, Alexandra Margarete ; Baecker, Hinnerk ; Yilmaz, Emre ; Jansen, Oliver ; Waydhas, Christian ; Schildhauer, Thomas Armin ; Hamsen, Uwe</creatorcontrib><description>Introduction
Prosthetic joint infection (PJI) is a severe complication after total joint replacement surgery. The current study analyzes the outcome and mortality of patients admitted to an intensive care unit following PJI.
Methods
Retrospective analysis of all patients treated between 2012 and 2016 due to PJI in the surgical intensive care unit of a university hospital.
Results
A total of 124 patients were included. The mean age was 75 ± 11 years. Of those 124 patients, 85 patients (68.5%) suffered a prosthetic infection of the hip, 33 patients (27.3%) of the knee, six patients (4.8%) of hip and knee. 52 patients were male (40.9%). The assessed mean Simplified Acute Physiology Score II (SAPSII) was 29.6 ± 5.9. The mortality rate was 21% (26/124). Of surviving patients, 53.1% were discharged home, 25.5% were transferred to a nursing home, and 21.4% were transferred to a geriatric rehabilitation center. Comparing survivors to non-survivors, the non-survivor group showed a higher incidence of renal replacement therapy (46.1 vs 3.0%;
p
< 0.01), higher SAPSII on admission (35.7 vs. 29.0;
p
= 0.01) and higher Charlson Comorbidity Indices (CCI) (5.5 vs. 2.82;
p
< 0.01). The multivariate regression identified CCI (odds ratio 1.49;
p
< 0.01) and renal replacement therapy (odds ratio 12.4;
p
< 0.01) as independent risk factors for increased mortality.
Conclusions
Admission to an intensive care unit was associated with a mortality rate of 21%. Factors associated with poor outcomes included renal replacement therapy, higher admission SAPII scores, and higher admission Charlson comorbidity index. These factors could be used for individual risk assessment on admission to the ICU.</description><identifier>ISSN: 0936-8051</identifier><identifier>EISSN: 1434-3916</identifier><identifier>DOI: 10.1007/s00402-020-03471-x</identifier><identifier>PMID: 32388649</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Comorbidity ; Infections ; Intensive care ; Knee Revision Surgery ; Medicine ; Medicine & Public Health ; Mortality ; Orthopedics ; Prostheses ; Renal replacement therapy ; Risk factors ; Sepsis</subject><ispartof>Archives of orthopaedic and trauma surgery, 2020-08, Vol.140 (8), p.1081-1085</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020</rights><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-71a1e5c3fd7c389fa3e2eb8deeb8a3d1d9e1b2215f1780f0968a01a6976d40c73</citedby><cites>FETCH-LOGICAL-c375t-71a1e5c3fd7c389fa3e2eb8deeb8a3d1d9e1b2215f1780f0968a01a6976d40c73</cites><orcidid>0000-0002-6967-7816</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00402-020-03471-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00402-020-03471-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51298</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32388649$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pöll, Alexandra Margarete</creatorcontrib><creatorcontrib>Baecker, Hinnerk</creatorcontrib><creatorcontrib>Yilmaz, Emre</creatorcontrib><creatorcontrib>Jansen, Oliver</creatorcontrib><creatorcontrib>Waydhas, Christian</creatorcontrib><creatorcontrib>Schildhauer, Thomas Armin</creatorcontrib><creatorcontrib>Hamsen, Uwe</creatorcontrib><title>Risk factors and outcome of patients with periprosthetic joint infection admitted to intensive care unit</title><title>Archives of orthopaedic and trauma surgery</title><addtitle>Arch Orthop Trauma Surg</addtitle><addtitle>Arch Orthop Trauma Surg</addtitle><description>Introduction
Prosthetic joint infection (PJI) is a severe complication after total joint replacement surgery. The current study analyzes the outcome and mortality of patients admitted to an intensive care unit following PJI.
Methods
Retrospective analysis of all patients treated between 2012 and 2016 due to PJI in the surgical intensive care unit of a university hospital.
Results
A total of 124 patients were included. The mean age was 75 ± 11 years. Of those 124 patients, 85 patients (68.5%) suffered a prosthetic infection of the hip, 33 patients (27.3%) of the knee, six patients (4.8%) of hip and knee. 52 patients were male (40.9%). The assessed mean Simplified Acute Physiology Score II (SAPSII) was 29.6 ± 5.9. The mortality rate was 21% (26/124). Of surviving patients, 53.1% were discharged home, 25.5% were transferred to a nursing home, and 21.4% were transferred to a geriatric rehabilitation center. Comparing survivors to non-survivors, the non-survivor group showed a higher incidence of renal replacement therapy (46.1 vs 3.0%;
p
< 0.01), higher SAPSII on admission (35.7 vs. 29.0;
p
= 0.01) and higher Charlson Comorbidity Indices (CCI) (5.5 vs. 2.82;
p
< 0.01). The multivariate regression identified CCI (odds ratio 1.49;
p
< 0.01) and renal replacement therapy (odds ratio 12.4;
p
< 0.01) as independent risk factors for increased mortality.
Conclusions
Admission to an intensive care unit was associated with a mortality rate of 21%. Factors associated with poor outcomes included renal replacement therapy, higher admission SAPII scores, and higher admission Charlson comorbidity index. These factors could be used for individual risk assessment on admission to the ICU.</description><subject>Comorbidity</subject><subject>Infections</subject><subject>Intensive care</subject><subject>Knee Revision Surgery</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mortality</subject><subject>Orthopedics</subject><subject>Prostheses</subject><subject>Renal replacement therapy</subject><subject>Risk factors</subject><subject>Sepsis</subject><issn>0936-8051</issn><issn>1434-3916</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kU9PVDEUxRsjkQH8Ai5MEzduHt7-mfdel4aomJCQGFg3nfbW6TivHds-hG9PYRATF2zapPd3zz29h5B3DE4ZwPCpAEjgHXDoQMiBdbevyIJJITuhWP-aLECJvhthyQ7JUSkbAMZHBW_IoeBiHHupFmT9I5Rf1BtbUy7UREfTXG2akCZPd6YGjLXQP6Gu6Q5z2OVU6hprsHSTQqw0RI-2hhSpcVOoFR2tqb1WjCXcILUmI51jqCfkwJttwbdP9zG5_vrl6uy8u7j89v3s80VnxbCs3cAMw6UV3g1WjMobgRxXo8N2GOGYU8hWnLOlZ8MIHlQ_GmCmV0PvJNhBHJOPe91m9feMpeopFIvbrYmY5qK5BMa4lEI19MN_6CbNOTZ3jeL8YVvQN4rvKdv-XjJ6vcthMvlOM9APOeh9DrrloB9z0Let6f2T9Lya0D23_F18A8QeKK0Uf2L-N_sF2XsIs5Tj</recordid><startdate>20200801</startdate><enddate>20200801</enddate><creator>Pöll, Alexandra Margarete</creator><creator>Baecker, Hinnerk</creator><creator>Yilmaz, Emre</creator><creator>Jansen, Oliver</creator><creator>Waydhas, Christian</creator><creator>Schildhauer, Thomas Armin</creator><creator>Hamsen, Uwe</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6967-7816</orcidid></search><sort><creationdate>20200801</creationdate><title>Risk factors and outcome of patients with periprosthetic joint infection admitted to intensive care unit</title><author>Pöll, Alexandra Margarete ; Baecker, Hinnerk ; Yilmaz, Emre ; Jansen, Oliver ; Waydhas, Christian ; Schildhauer, Thomas Armin ; Hamsen, Uwe</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-71a1e5c3fd7c389fa3e2eb8deeb8a3d1d9e1b2215f1780f0968a01a6976d40c73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Comorbidity</topic><topic>Infections</topic><topic>Intensive care</topic><topic>Knee Revision Surgery</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mortality</topic><topic>Orthopedics</topic><topic>Prostheses</topic><topic>Renal replacement therapy</topic><topic>Risk factors</topic><topic>Sepsis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pöll, Alexandra Margarete</creatorcontrib><creatorcontrib>Baecker, Hinnerk</creatorcontrib><creatorcontrib>Yilmaz, Emre</creatorcontrib><creatorcontrib>Jansen, Oliver</creatorcontrib><creatorcontrib>Waydhas, Christian</creatorcontrib><creatorcontrib>Schildhauer, Thomas Armin</creatorcontrib><creatorcontrib>Hamsen, Uwe</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of orthopaedic and trauma surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pöll, Alexandra Margarete</au><au>Baecker, Hinnerk</au><au>Yilmaz, Emre</au><au>Jansen, Oliver</au><au>Waydhas, Christian</au><au>Schildhauer, Thomas Armin</au><au>Hamsen, Uwe</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk factors and outcome of patients with periprosthetic joint infection admitted to intensive care unit</atitle><jtitle>Archives of orthopaedic and trauma surgery</jtitle><stitle>Arch Orthop Trauma Surg</stitle><addtitle>Arch Orthop Trauma Surg</addtitle><date>2020-08-01</date><risdate>2020</risdate><volume>140</volume><issue>8</issue><spage>1081</spage><epage>1085</epage><pages>1081-1085</pages><issn>0936-8051</issn><eissn>1434-3916</eissn><abstract>Introduction
Prosthetic joint infection (PJI) is a severe complication after total joint replacement surgery. The current study analyzes the outcome and mortality of patients admitted to an intensive care unit following PJI.
Methods
Retrospective analysis of all patients treated between 2012 and 2016 due to PJI in the surgical intensive care unit of a university hospital.
Results
A total of 124 patients were included. The mean age was 75 ± 11 years. Of those 124 patients, 85 patients (68.5%) suffered a prosthetic infection of the hip, 33 patients (27.3%) of the knee, six patients (4.8%) of hip and knee. 52 patients were male (40.9%). The assessed mean Simplified Acute Physiology Score II (SAPSII) was 29.6 ± 5.9. The mortality rate was 21% (26/124). Of surviving patients, 53.1% were discharged home, 25.5% were transferred to a nursing home, and 21.4% were transferred to a geriatric rehabilitation center. Comparing survivors to non-survivors, the non-survivor group showed a higher incidence of renal replacement therapy (46.1 vs 3.0%;
p
< 0.01), higher SAPSII on admission (35.7 vs. 29.0;
p
= 0.01) and higher Charlson Comorbidity Indices (CCI) (5.5 vs. 2.82;
p
< 0.01). The multivariate regression identified CCI (odds ratio 1.49;
p
< 0.01) and renal replacement therapy (odds ratio 12.4;
p
< 0.01) as independent risk factors for increased mortality.
Conclusions
Admission to an intensive care unit was associated with a mortality rate of 21%. Factors associated with poor outcomes included renal replacement therapy, higher admission SAPII scores, and higher admission Charlson comorbidity index. These factors could be used for individual risk assessment on admission to the ICU.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>32388649</pmid><doi>10.1007/s00402-020-03471-x</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0002-6967-7816</orcidid></addata></record> |
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| source | Springer Nature - Complete Springer Journals |
| subjects | Comorbidity Infections Intensive care Knee Revision Surgery Medicine Medicine & Public Health Mortality Orthopedics Prostheses Renal replacement therapy Risk factors Sepsis |
| title | Risk factors and outcome of patients with periprosthetic joint infection admitted to intensive care unit |
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