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Risk of inpatient surgical-site infection after shoulder arthroplasty higher in certain patients
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Recently published data indicated patients were at a higher risk for inpatient surgical-site infection after shoulder arthroplasty if they had total shoulder arthroplasty, Medicaid insurance, history of a previous nonunion or certain comorbidities.
Researchers identified and analyzed data for 241,193 patients from the Nationwide Inpatient Sample who underwent either total shoulder arthroplasty (TSA) or reverse TSA and 159,795 patients who underwent hemiarthroplasty (HSA), noting patients with a surgical site infection (SSI) diagnosis during admission.
Each patient group was evaluated for explanatory variables including age, sex, insurance status, comorbidities, primary diagnosis, year of surgery and length of hospitalization. In addition, the researchers calculated rates of SSI for each explanatory data. To determine any correlation between the variables evaluated and SSI diagnosis, the researchers conducted multivariable binary logistic regression analysis.
Results showed, during the 10-year study period, 0.08% of patients who underwent TSA or reverse TSA and 0.11% of patients who underwent HSA developed SSI at time of surgery. Longer hospital stay; TSA; Medicaid insurance; various comorbidities, such as coagulopathy and renal failure; and adverse hospital events were correlated with SSI in-hospital diagnosis according to results of a bivariate analysis. Specifically, longer hospital stay, nonroutine discharge, pneumonia, blood transfusion, mechanical ventilation, acute renal failure and gastrointestinal complications were the hospital events found to be correlated with SSI. For every additional inpatient care day, the chance of SSI increased by 14%, according to the researchers.
Eighty-five percent of patients overall who underwent repeat surgery had a prosthesis removed or exchanged polyethylene liners, whereas 15% had irrigation and debridement without hardware removal, according to the researchers. ‒ by Monica Jaramillo
Disclosures: Smuncy reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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