RISK FACTORS FOR INFECTION IN TOTAL JOINT ARTHROPLASTY

Purpose: Infections can be a serious complication following total joint arthroplasty. Several risk factors for increased incidence of infection have been previously reported. The purpose of this study is to evaluate the patient population at JPS for risk factors that may be associated with higher rates of infection. Our hypothesis is that patients with a BMI>30 and other comorbidities are more likely to have a post-surgical complication following total joint arthroplasty when compared to non-obese, healthy patients. Methods: Retrospective chart review of approximately 261 patients from 2008-2012. Charts were analyzed for general demographics, complications, age/gender, health status, prophylactic antibiotics, and surgery time. Patients who were receiving either knee or hip surgery were documented. Each patient was assessed for their degree of general health using BMI, ASA and CCI scores. These categories were compared between patients with complication and those without complications. Results: From the criteria gathered, a nonparametric logistic regression was utilized in order to determine the extent of correlation regarding risk factors for infection. The objective was to determine if there were any risk factors that were recorded that coincided with infection status of patients that have received total joint arthroplasty. After adjusting for confounders, the resulting p-value (0.869) from the sample suggested that there was no significance of risk factors in regards to infection status within the study. In addition, the deep infection rate (15.3 per 1000 cases) exhibits superior performance in regards to surgery and the afflictions that can influence patients. Along with this, the infection rate of the study (84.3 per 1000 cases) may suggest that in the future, the quality of care may be perceived in a more important manner. Conclusions: Although this study didn't yield the results we were looking for, we still have hope for our hypothesis both in the hip subsection and total joints overall as this study continues. One limitation on our study was a smaller than expected patient enrollment. This being a retrospective study, some of the older charts were not available for review, which limited our numbers. That being so, our total enrollment for hips and knees were reduced from approximately 400 patients to 261; with this smaller sample size our data may not truly represent the population from which it is derived.