Abstract
Abstract. Introduction Periprosthetic joint infections (PJI) are serious complications of total hip arthroplasty (THA) and affect the patient's life expectancy. The aim of the study was to identify independent factors influencing the risk of death in patients with PJI after revision THA. Materials and methods The study included 51 lethal outcomes in patients with chronic PJI of the hip. Results and discussion In our cohort of 434 patients, 13 (2.99 %) patients died within the first year after surgery (p > 0.05), which is 2.2 times less than similar published data. The result of gender analysis showed no statistically significant differences in the risk of death between men and women (OR1.05 CI 0.59–1.89, p = 0.87). It was found that in patients over 70 years old, the risk of death was significantly higher (OR 2.05 CI 1.09–3.87, p = 0.031). Additional independent risk factors of death are diseases of the cardiovascular system. It was not possible to find a statistically significant effect of the nature of infection on the risk of death: no growth (OR 2.23, CI 0.52–9.61), monomicrobial infection (OR 1.98, CI 0.45–8, 73), polymicrobial infection (OR 3.2, CI 0.71–14.45, p > 0.05). Conclusion The mortality rate during the first year after revision THA in patients with PJI was 2.99 %, which is lower than the results of other researchers. In the next 2–3 years, the rate of death increases 3.9 times. The main independent risk factors are the age of patients and concomitant diseases of the cardiovascular system.
Highlights
Periprosthetic joint infections (PJI) are serious complications of total hip arthroplasty (THA) and affect the patient's life expectancy
Cancienne et al (2017) pointed out that, probably, these indicators do not reflect the real state of affairs, since information about the fate of some patients was absent in national databases [26]
Our work found a trend indicating the impact of pathogenic microflora on lethal outcomes
Summary
Periprosthetic joint infections (PJI) are serious complications of total hip arthroplasty (THA) and affect the patient's life expectancy. Materials and methods The study included 51 lethal outcomes in patients with chronic PJI of the hip. The treatment of PJI requires the use of aggressive surgical techniques, repeated surgeries, long-term systemic antibiotic therapy (ABT), which together affect the patient's life expectancy [6–9]. Zmistowski et al (2013), mortality was significantly higher (p < 0.001) among patients with PJI compared with patients after aseptic revision: 3.7 % and 0.8 % 90 days after surgery, respectively, 10.6 % and 2 , 0 % after one year, 13.6 % and 3.9 % after two years, and 25.9 % and 12.9 % after five years [11]. The authors compared the data obtained with the survival rate after treatment of the five most common cancers: prostate – 99 %, breast – 89 %, lung – 16 %, colorectal cancer – 64 % and melanoma – 91 % [12, 13]
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