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Title: Clinical outcome and risk factors for failure in late acute prosthetic joint infections treated with debridement and implant retention
Author: Wouthuyzen-Bakker, Marjan
Sebillotte, Marine
Lomas, Jose
Taylor, Adrian
Benavent Palomares, Eva
Murillo Rubio, Óscar
Parvizi, Javad
Shohat, Noam
Cobo Reinoso, Javier
Escudero, Rosa
Fernandez-Sampedro, Marta
Senneville, Eric
Huotari, Kaisa
Barbero, José Maria
Garcia-Cañete, Joaquín
Lora-Tamayo, Jaime
Ferrari, Matteo Carlo
Vaznaisiene, Danguole
Yusuf, Erlangga
Aboltins, Craig
Trebse, Rihard
Salles, Mauro José
Benito Hernández, M. Natividad de
Vila, Andrea
Toro, Maria Dolores del
Kramer, Tobias Siegfried
Petersdorf, Sabine
Diaz-Brito, Vicens
Tufan, Zeliha Kocak
Sanchez, Marisa
Arvieux, Cédric
Soriano Viladomiu, Alex
ESCMID Study Group for Implant-Associated Infectio
Keywords: Pròtesis
Factors de risc en les malalties
Risk factors in diseases
Issue Date: 1-Jan-2019
Publisher: Elsevier
Abstract: Objectives: debridement, antibiotics and implant retention (DAIR) is the recommended treatment for all acute prosthetic joint infections (PJI), but its efficacy in patients with late acute (LA) PJI is not well described. Methods: patients diagnosed with LA PJI between 2005 and 2015 were retrospectively evaluated. LA PJI was defined as the development of acute symptoms (≤ 3 weeks) occurring ≥ 3 months after arthroplasty. Failure was defined as: (i) the need for implant removal, (ii) infection related death, (iii) the need for suppressive antibiotic therapy and/or (iv) relapse or reinfection during follow-up. Results: 340 patients from 27 centers were included. The overall failure rate was 45.0% (153/340). Failure was dominated by Staphylococcus aureus PJI (54.7%, 76/139). Significant independent preoperative risk factors for failure according to the multivariate analysis were: fracture as indication for the prosthesis (odds ratio (OR) 5.4), rheumatoid arthritis (OR 5.1), age above 80 years (OR 2.6), male gender (OR 2.0) and C-reactive protein > 150 mg/L (OR 2.0). Exchanging the mobile components during DAIR was the strongest predictor for treatment success (OR 0.35). Conclusion: LA PJIs have a high failure rate. Treatment strategies should be individualized according to patients' age, comorbidity, clinical presentation and microorganism causing the infection.
Note: Versió postprint del document publicat a:
It is part of: Journal of Infection, 2019, vol. 78, num. 1, p. 40-47
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ISSN: 0163-4453
Appears in Collections:Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
Articles publicats en revistes (Medicina)
Articles publicats en revistes (Ciències Clíniques)

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