Friday, September 20, 2013

Infection risk increased by revision surgery, obesity, diabetes, smoking

Medical Comorbidities Are Independent Preoperative Risk Factors for Surgical Infection After Total Joint Arthroplasty

These authors records of patients undergoing total joint arthroplasty, finding 29 culture-positive surgical site infections (1.5% of total number of cases. The most common infecting organisms were  methicillin-resistant Staphylococcus aureus (34.5%) and gram-negative rods (31.0%). Independent risk factors for infection included: revision surgery (OR 2.28), body mass index > 50 kg/m2 ( OR, 5.28), diabetes mellitus (OR, 1.83), tobacco abuse (OR, 2.96), MRSA colonization or infection (OR, 4.17), and current or prior bone cancer (OR, 3.86).

So here again we have the concept of the 4 Ps and the importance of the second P (the patient) in determining the outcome.

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