Obesity, pathologic weight loss may predict infection after THA for acetabular fractures
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Obesity, depression, morbid weight loss and iron deficiency anemia may be risk factors for surgical site and periprosthetic joint infections in patients undergoing total hip arthroplasty for acetabular fractures, according to results.
“Recent studies have shown primary THA for the treatment of acetabular fractures to be superior to open reduction internal fixation especially in the elderly population,” said Angelo Mannino, MD, who presented findings on risk factors for infection after THA at the Musculoskeletal Infection Society Annual Meeting. The meeting was held virtually.
“Currently, there are no well powered studies that evaluate patient demographics or identifying risk factors for infections in this group of patients,” Mannino said in his presentation.
Mannino and colleagues from Maimonides Medical Center in Brooklyn performed a retrospective query of 997 patients who underwent primary THA for ipsilateral acetabular fractures from Jan. 1, 2005 to March 31, 2014 and developed a surgical site infection (SSI, n=429) or periprosthetic joint infection (PJI, n=568).
According to the study, researchers compared patient demographics, such as age, sex and Elixhauser Comorbidity Index (ECI), between 997 patients with infections and a control group of 11,074 patients who did not develop infections. They also completed multivariate binomial logistic regression analyses to calculate SSI and PJI risks.
“The study found that the greatest odds for developing a surgical site infection were obesity, pathological weight loss and depression,” Mannino said. “Whereas the greatest risk factors for periprosthetic joint infections were iron deficiency, anemia, pathologic weight loss and morbid obesity.”
Mannino and colleagues also found patients who developed infections were generally older, male patients and had a significantly higher ECI.
“This study corroborates with the existing literature that patients with acetabular fractures who were treated with a THA – whether primarily or as a second procedure – had a much higher risk for infection,” Mannino added. “So, future studies should go on to evaluate the severity and duration of these risk factors for the development of infections,” he said.
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Vakharia R, et al. Presentation 105. Presented at: Musculoskeletal Infection Society Annual Meeting; Aug. 7-8, 2020 (virtual meeting).
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