Obesity, Diabetes, and Preoperative Hyperglycemia as Predictors of Periprosthetic Joint Infection

• DOI: 10.2106/jbjs.j.01935
• Publication Date: 2012-11-15T20:56:37Z
• Authors: Esa Jämsen; Pasi Nevalainen; Antti Eskelinen; Kaisa Huotari; Jarkko Kalliovalkama; Teemu Moilanen
• Keywords: Adult; Male; Prosthesis-Related Infections; Comorbidity; 03 medical and health sciences; 0302 clinical medicine; Osteoarthritis; Diabetes Mellitus; Humans; Obesity; Finland; Aged; Aged, 80 and over; 2. Zero hunger; Incidence; Middle Aged; Obesity, Morbid; 3. Good health; Hyperglycemia; Multivariate Analysis; Preoperative Period; Female; Hip Prosthesis; Knee Prosthesis

Background: Diabetes and obesity are common in patients undergoing joint replacement. Studies analyzing the effects of diabetes on occurrence periprosthetic infection have yielded contradictory results, combined these conditions not known. Methods: The one-year incidence infections was analyzed a single-center series 7181 primary hip knee replacements (unilateral simultaneous bilateral) performed between 2002 2008 to treat osteoarthritis. data regarding (defined according Centers for Disease Control Prevention criteria) were collected from hospital register based prospective, active surveillance. Patients diagnosed with identified registers Social Insurance Institution Finland. odds ratios (ORs) accompanying 95% confidence intervals (CIs) calculated use binary logistic regression adjustment age, sex, American Society Anesthesiologists risk score, arthroplasty site, body mass index, diabetic status. Results: Fifty-two occurred during first postoperative year (0.72%; CI, 0.55% 0.95%). rate increased 0.37% (95% 0.15% 0.96%) normal index 4.66% 2.47% 8.62%) morbidly obese group (adjusted OR, 6.4; 1.7 24.6). more than doubled independent 2.3; 1.1 4.7). highest diabetes; this contained fifty-one developed five (9.8%; 4.26% 20.98%). In without diagnosis at time surgery, there trend toward higher association preoperative glucose level ≥6.9 mmol/L (124 mg/dL) compared <6.9 mmol/L. 1.15% 0.56% 2.35%) former 0.28% 0.53%) latter, adjusted OR 3.3 0.96 11.0). type medication associated rate. Conclusions: morbid following benefits replacement should be carefully weighed against infection, especially patients. Level Evidence: Prognostic II. See Instructions Authors complete description levels evidence.