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2019-01-01

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cc-by-nc-nd (c) The British Infection Association, 2019
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/171880

Clinical outcome and risk factors for failure in late acute prosthetic joint infections treated with debridement and implant retention

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https://doi.org/10.1016/j.jinf.2018.07.014

Resum

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.

Matèries

Pròtesis, Estadística, Factors de risc en les malalties

Matèries (anglès)

Prosthesis, Statistics, Risk factors in diseases

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Articles publicats en revistes (Ciències Clíniques)
Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
Articles publicats en revistes (Medicina)

Citació

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, DÍAZ BRITO, Vicens, TUFAN, Zeliha kocak, SANCHEZ, Marisa, ARVIEUX, Cédric, SORIANO VILADOMIU, Alex, ESCMID Study Group for Implant-Associated Infectio. Clinical outcome and risk factors for failure in late acute prosthetic joint infections treated with debridement and implant retention. _Journal of Infection_. 2019. Vol. 78, núm. 1, pàgs. 40-47. [consulta: 8 de abril de 2026]. ISSN: 0163-4453. [Disponible a: https://hdl.handle.net/2445/171880]

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