Increased trends in PJI rates found among patients undergoing revision THA

DALLAS— Data presented at the American Association of Hip and Knee Surgeons Annual Meeting showed an increasing trend of periprosthetic joint infection among patients undergoing revision total hip arthroplasty.

“Infections should never be called a ‘never event’ for as long as we continue to operate, we will forever have infection,” Calin S. Moucha, MD, told Healio.com/Orthopedics. “The key is to try to prevent infections as best as possible and when they do happen, diagnose them in a timely manner and treat appropriately.”

Moucha and colleagues assessed patients from the National Inpatient Sample database who underwent revision THA from 2002 to 2013 for trends in periprosthetic joint infection (PJI) and associated total inpatient costs regarding PJI revision. They stratified by hospital size, hospital area and hospital teaching status.

Results showed PJI was the indicator for 15.1% of all revisions. Furthermore, PJI increased from 13% in 2003 to 16.3% in 2013. Researchers noted rural hospitals had the lowest burden of PJI, while urban, teaching hospitals had the highest PJI burden. Researchers also found an increasing trend in total hospital costs for PJI and non-PJI revisions, with an average of 27.3% higher costs for PJI-related revisions and higher costs in hospitals located in the West.

“Infection case rates increased significantly over the study period for all hospital types, and there were no significant trends in cost — not charges, like some previous studies — between hospital types,” Moucha said. “PJI burden was comparable in hospital sizes, with increasing rates in medium and large hospitals. Costs in large hospitals significantly increased.”

He added that all types of hospitals had increased trends in revisions for PJI, as well as associated costs.

After identifying these trends, Moucha said it is important to identify the cause of this increase in PJI.

“This data should serve as a good platform for further investigations as to why we are seeing increasing trends in PJI infection risk,” he said. “Specifically, we plan on looking at other more comprehensive databases to evaluate whether these are early or late revisions for infections. Trying to better understand why we are seeing these trends is obviously the next step.” – by Casey Tingle and Susan Rapp

Reference:

Brochin RL, et al. Poster #160. Presented at: American Association of Hip and Knee Surgeons Annual Meeting; Nov. 2-5, 2017; Dallas, Texas.

Disclosure: Moucha reports he is a paid presenter or speaker for 3M.