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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 Morillo-Velarde, 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 Estadística Factors de risc en les malalties Prosthesis Statistics 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: https://doi.org/10.1016/j.jinf.2018.07.014 |
It is part of: | Journal of Infection, 2019, vol. 78, num. 1, p. 40-47 |
URI: | http://hdl.handle.net/2445/171880 |
Related resource: | https://doi.org/10.1016/j.jinf.2018.07.014 |
ISSN: | 0163-4453 |
Appears in Collections: | Articles publicats en revistes (Medicina) Articles publicats en revistes (Ciències Clíniques) Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL)) |
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