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PJI burden greater with increased infection rates, occurrences of shoulder arthroplasty
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Increasing rates of infection and occurrences of shoulder arthroplasties are estimated to result in an overall greater burden of periprosthetic joint infection, according to research findings; however, periprosthetic joint infection hospitalization costs were found to be equivalent to those of primary shoulder arthroplasty.
Researchers identified 82,498 patients from the Nationwide Inpatient Sample (NIS) who underwent primary shoulder arthroplasties between Jan. 1, 2002, to Dec. 21, 2011, using the ICD-9-CM codes for total shoulder arthroplasty (TSA), hemiarthroplasty (HSA) and reverse shoulder arthroplasty (RSA). NIS data for weight, survey stratification and clustering factors were utilized to obtain an estimation of the national rate for periprosthetic joint infection (PJI) and confidence interval (CI). ICD-9-CM coded age, gender, ethnicity and 15 medical comorbidities were analyzed with multivariate regression analysis to identify any potential association with PJI. The researchers also examined PJI’s effect on hospitalization and length of stay.
Results showed 808 out of the 82,498 primary shoulder athroplasties were diagnosed with infections during index procedure or later on when the patient returned for arthrotomy. The infection rate overall was 0.98%.
Higher rates of PJI were correlated with younger age and male gender, according to the researchers. The comorbidities most strongly correlated with an increased chance of PJI were weight loss / nutritional deficiency, drug abuse and anemia due to blood loss or iron deficiency.
According to the researchers, median hospital length of stay for PJI was 4 days compared with 2 days for primary shoulder arthroplasty. The median hospital costs in 2011 for TSA, HSA and RSA were $16,132.68, $13,955.83 and $20,007.87, respectively, compared with $17,163.57 for PJI. ‒ by Monica Jaramillo
Disclosures: Padegimas reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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