Surgical site infection in overweight and obese Total Knee Arthroplasty patients

Surgical site infection in overweight and obese Total Knee Arthroplasty patients

Abstract Purpose This aim of this study was to evaluate the rate of surgical site infection (SSI) in patients undergoing Total Knee Arthroplasty (TKA), to improve our understanding of the associations between infection rate and obesity. Methods Data was reviewed for 839 primary TKA procedures perfor...

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Veröffentlicht in:Journal of orthopaedics 2018-06, Vol.15 (2), p.328-332
Hauptverfasser: Wilson, Christopher John, Georgiou, Kristen Renee, Oburu, Ezekiel, Theodoulou, Annika, Deakin, Angela H, Krishnan, Jeganath
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Body mass index
Obesity
Orthopedics
Surgical site infection
Total knee arthroplasty
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container_end_page 332
container_issue 2
container_start_page 328
container_title Journal of orthopaedics
container_volume 15
creator Wilson, Christopher John
Georgiou, Kristen Renee
Oburu, Ezekiel
Theodoulou, Annika
Deakin, Angela H
Krishnan, Jeganath
description Abstract Purpose This aim of this study was to evaluate the rate of surgical site infection (SSI) in patients undergoing Total Knee Arthroplasty (TKA), to improve our understanding of the associations between infection rate and obesity. Methods Data was reviewed for 839 primary TKA procedures performed at a National Arthroplasty Centre over one year (April 2007–March 2008). SSI data was collected at 30 days and one year post-operatively. Patients were grouped guided by the WHO classifications of obesity; normal (BMI 
doi_str_mv 10.1016/j.jor.2018.02.009
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Methods Data was reviewed for 839 primary TKA procedures performed at a National Arthroplasty Centre over one year (April 2007–March 2008). SSI data was collected at 30 days and one year post-operatively. Patients were grouped guided by the WHO classifications of obesity; normal (BMI &lt; 25.0), overweight (BMI 25.00–29.99), obese class I (BMI 30.00–34.99), obese class II (BMI 35.00–39.99), obese class III (BMI ≥ 40.00). Statistical significance was assessed by Fisher’s Exact Test. Results When grouped by BMI, 30.9% of patients were obese class I, 19.0% obese class II and 8.7% obese class III. Of the total cohort, 22 patients (2.6%) had superficial SSI and 13 (1.5%) had deep SSI. When comparing the obese class III cohort to all other cohorts (non-obese class III), the odds ratios for superficial SSI was 4.20 (95% CI [1.59, 11.09]; p = 0.009) and deep SSI was 6.97 (95% CI [2.22, 21.89]; p = 0.003). In the obese class III cohort, superficial SSI rate was higher in females (8.9%) than males (5.9%), yet deep SSI demonstrated the opposite, with a higher occurrence in males (11.8%) compared to females (5.4%). Conclusion This study suggests that obese class III TKA patients are at increased odds of superficial and deep SSI compared to other BMI cohorts. Interestingly, male obese class III patients demonstrated a higher rate of deep infection compared to their female counterparts. However, it must be noted that study findings are limited as confounders were unable to be accounted for in this retrospective study design.</description><identifier>ISSN: 0972-978X</identifier><identifier>EISSN: 0972-978X</identifier><identifier>DOI: 10.1016/j.jor.2018.02.009</identifier><identifier>PMID: 29881146</identifier><language>eng</language><publisher>India: Elsevier, a division of RELX India, Pvt. Ltd</publisher><subject>Body mass index ; Obesity ; Orthopedics ; Surgical site infection ; Total knee arthroplasty</subject><ispartof>Journal of orthopaedics, 2018-06, Vol.15 (2), p.328-332</ispartof><rights>Prof. PK Surendran Memorial Education Foundation</rights><rights>2018 Prof. PK Surendran Memorial Education Foundation</rights><rights>2018 Prof. PK Surendran Memorial Education Foundation. Published by Elsevier, a division of RELX India, Pvt. Ltd. All rights reserved. 2018 Prof. PK Surendran Memorial Education Foundation</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c506t-4cffd12381f2da76d5a94a24b2ff08af3613db57f4e8e0ccfba0dbc4507ea6283</citedby><cites>FETCH-LOGICAL-c506t-4cffd12381f2da76d5a94a24b2ff08af3613db57f4e8e0ccfba0dbc4507ea6283</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5990115/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5990115/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29881146$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wilson, Christopher John</creatorcontrib><creatorcontrib>Georgiou, Kristen Renee</creatorcontrib><creatorcontrib>Oburu, Ezekiel</creatorcontrib><creatorcontrib>Theodoulou, Annika</creatorcontrib><creatorcontrib>Deakin, Angela H</creatorcontrib><creatorcontrib>Krishnan, Jeganath</creatorcontrib><title>Surgical site infection in overweight and obese Total Knee Arthroplasty patients</title><title>Journal of orthopaedics</title><addtitle>J Orthop</addtitle><description>Abstract Purpose This aim of this study was to evaluate the rate of surgical site infection (SSI) in patients undergoing Total Knee Arthroplasty (TKA), to improve our understanding of the associations between infection rate and obesity. Methods Data was reviewed for 839 primary TKA procedures performed at a National Arthroplasty Centre over one year (April 2007–March 2008). SSI data was collected at 30 days and one year post-operatively. Patients were grouped guided by the WHO classifications of obesity; normal (BMI &lt; 25.0), overweight (BMI 25.00–29.99), obese class I (BMI 30.00–34.99), obese class II (BMI 35.00–39.99), obese class III (BMI ≥ 40.00). Statistical significance was assessed by Fisher’s Exact Test. Results When grouped by BMI, 30.9% of patients were obese class I, 19.0% obese class II and 8.7% obese class III. Of the total cohort, 22 patients (2.6%) had superficial SSI and 13 (1.5%) had deep SSI. When comparing the obese class III cohort to all other cohorts (non-obese class III), the odds ratios for superficial SSI was 4.20 (95% CI [1.59, 11.09]; p = 0.009) and deep SSI was 6.97 (95% CI [2.22, 21.89]; p = 0.003). In the obese class III cohort, superficial SSI rate was higher in females (8.9%) than males (5.9%), yet deep SSI demonstrated the opposite, with a higher occurrence in males (11.8%) compared to females (5.4%). Conclusion This study suggests that obese class III TKA patients are at increased odds of superficial and deep SSI compared to other BMI cohorts. Interestingly, male obese class III patients demonstrated a higher rate of deep infection compared to their female counterparts. However, it must be noted that study findings are limited as confounders were unable to be accounted for in this retrospective study design.</description><subject>Body mass index</subject><subject>Obesity</subject><subject>Orthopedics</subject><subject>Surgical site infection</subject><subject>Total knee arthroplasty</subject><issn>0972-978X</issn><issn>0972-978X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp9Uk2LFDEUDKK4H_oDvEgfvUz7kv5KIywsi67igsKu4C2kk5eZtD3JmKRH5t-bZtZl9eApBamq96h6hLyiUFKg7duxHH0oGVBeAisB-ifkFPqOrfqOf3_6CJ-QsxhHgIo1bfWcnLCec0rr9pR8vZ3D2io5FdEmLKwzqJL1LqPC7zH8QrvepEI6XfgBIxZ3PmXyZ4dYXIa0CX43yZgOxU4miy7FF-SZkVPEl_fvOfn24f3d1cfVzZfrT1eXNyvVQJtWtTJGU1ZxapiWXasb2deS1QMzBrg0VUsrPTSdqZEjKGUGCXpQdQMdypbx6pxcHH1387BFrfLsICexC3Yrw0F4acXfP85uxNrvRdP3QGmTDd7cGwT_c8aYxNZGhdMkHfo5CgYN4xSAd5lKj1QVfIwBzcMYCmJpQowiNyGWJgQwkZvImteP93tQ_Ik-E94dCZhT2lsMIqqcoEJtQ-5AaG__a3_xj1pN1i1F_sADxtHPweX4BRUxC8TtcgrLJdCuggyg-g1lNbGJ</recordid><startdate>20180601</startdate><enddate>20180601</enddate><creator>Wilson, Christopher John</creator><creator>Georgiou, Kristen Renee</creator><creator>Oburu, Ezekiel</creator><creator>Theodoulou, Annika</creator><creator>Deakin, Angela H</creator><creator>Krishnan, Jeganath</creator><general>Elsevier, a division of RELX India, Pvt. Ltd</general><general>Elsevier</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20180601</creationdate><title>Surgical site infection in overweight and obese Total Knee Arthroplasty patients</title><author>Wilson, Christopher John ; Georgiou, Kristen Renee ; Oburu, Ezekiel ; Theodoulou, Annika ; Deakin, Angela H ; Krishnan, Jeganath</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c506t-4cffd12381f2da76d5a94a24b2ff08af3613db57f4e8e0ccfba0dbc4507ea6283</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Body mass index</topic><topic>Obesity</topic><topic>Orthopedics</topic><topic>Surgical site infection</topic><topic>Total knee arthroplasty</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wilson, Christopher John</creatorcontrib><creatorcontrib>Georgiou, Kristen Renee</creatorcontrib><creatorcontrib>Oburu, Ezekiel</creatorcontrib><creatorcontrib>Theodoulou, Annika</creatorcontrib><creatorcontrib>Deakin, Angela H</creatorcontrib><creatorcontrib>Krishnan, Jeganath</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of orthopaedics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wilson, Christopher John</au><au>Georgiou, Kristen Renee</au><au>Oburu, Ezekiel</au><au>Theodoulou, Annika</au><au>Deakin, Angela H</au><au>Krishnan, Jeganath</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Surgical site infection in overweight and obese Total Knee Arthroplasty patients</atitle><jtitle>Journal of orthopaedics</jtitle><addtitle>J Orthop</addtitle><date>2018-06-01</date><risdate>2018</risdate><volume>15</volume><issue>2</issue><spage>328</spage><epage>332</epage><pages>328-332</pages><issn>0972-978X</issn><eissn>0972-978X</eissn><abstract>Abstract Purpose This aim of this study was to evaluate the rate of surgical site infection (SSI) in patients undergoing Total Knee Arthroplasty (TKA), to improve our understanding of the associations between infection rate and obesity. Methods Data was reviewed for 839 primary TKA procedures performed at a National Arthroplasty Centre over one year (April 2007–March 2008). SSI data was collected at 30 days and one year post-operatively. Patients were grouped guided by the WHO classifications of obesity; normal (BMI &lt; 25.0), overweight (BMI 25.00–29.99), obese class I (BMI 30.00–34.99), obese class II (BMI 35.00–39.99), obese class III (BMI ≥ 40.00). Statistical significance was assessed by Fisher’s Exact Test. Results When grouped by BMI, 30.9% of patients were obese class I, 19.0% obese class II and 8.7% obese class III. Of the total cohort, 22 patients (2.6%) had superficial SSI and 13 (1.5%) had deep SSI. When comparing the obese class III cohort to all other cohorts (non-obese class III), the odds ratios for superficial SSI was 4.20 (95% CI [1.59, 11.09]; p = 0.009) and deep SSI was 6.97 (95% CI [2.22, 21.89]; p = 0.003). In the obese class III cohort, superficial SSI rate was higher in females (8.9%) than males (5.9%), yet deep SSI demonstrated the opposite, with a higher occurrence in males (11.8%) compared to females (5.4%). Conclusion This study suggests that obese class III TKA patients are at increased odds of superficial and deep SSI compared to other BMI cohorts. Interestingly, male obese class III patients demonstrated a higher rate of deep infection compared to their female counterparts. However, it must be noted that study findings are limited as confounders were unable to be accounted for in this retrospective study design.</abstract><cop>India</cop><pub>Elsevier, a division of RELX India, Pvt. Ltd</pub><pmid>29881146</pmid><doi>10.1016/j.jor.2018.02.009</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record>
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source Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Alma/SFX Local Collection
subjects Body mass index
Obesity
Orthopedics
Surgical site infection
Total knee arthroplasty
title Surgical site infection in overweight and obese Total Knee Arthroplasty patients
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