PJI after THA may be associated with more than fivefold increase in 10-year mortality rate
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Key takeaways:
- Joint infection within 1 year after hip arthroplasty may increase patients’ risk for mortality within 10 years.
- Mortality rates were 11.4% vs. 2.2% among patients with vs. without infection, respectively.
According to published results, patients with periprosthetic joint infection within 1 year after total hip arthroplasty may be at a significantly increased risk for mortality within 10 years after index THA.
Raman Mundi, MD, MSc, FRCSC, assistant professor in the department of surgery at the University of Toronto and surgeon scientist in the division of orthopedic surgery at Sunnybrook Health Sciences Centre, and colleagues performed a population-based, retrospective cohort study of 175,432 patients (mean age, 67 years) who underwent primary THA between 2002 and 2021. Among the cohort, 0.49% of patients (n = 868) underwent surgery for PJI within 1 year after index THA.
Mundi and colleagues performed a subanalysis of two cohorts of 827 patients (one group with and one group without PJI) who were propensity score-matched for age, sex, income and comorbidities.
After matching, Mundi and colleagues found patients who underwent surgery for PJI within 1 year had a significantly higher 10-year mortality rate compared with patients without PJI (11.4% vs. 2.2%; HR = 5.49).
Mundi and colleagues found patients with PJI had significantly increased rates of mortality at 10 years vs. patients without PJI when matched by primary surgeon (HR = 3.28) and excluding patients older than 60 years (HR = 10.18). They noted no significant association between postoperative pneumonia and 10-year mortality rates between the groups (HR = 0.22).
“The results of this study build on previous evidence to help delineate the causal association between PJI and increased mortality risk,” Mundi and colleagues wrote in the study. “These findings should help to bolster efforts related to the prevention, diagnosis and treatment of PJIs, which may be considered among the most important priorities for future musculoskeletal research.”
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