Ретроспективный анализ факторов риска развития гнойно-септических осложнений у ортопедических пациентов

Abstract

Despite advances and improvements in infection prevention techniques, periprosthetic joint infection is a serious complication after total joint replacement. Prevention of purulent-septic complications is the most important strategy to combat this disabling complication, and should begin with identifying patient-related risk factors The aim: identification of risk factors associated with the development of purulent-septic complications after total arthroplasty of large joints. Methods. A retrospective review of the medical records of 71 patients who underwent orthopedic surgery from September 2022 to August 2023 was performed. Taking into account the development of purulent-septic complications, the patients were divided into 2 groups. Group I included patients with infectious complications after surgery, such as periprosthetic infection (n=9), suppuration of the surgical wound (n=8), respiratory infection (n=2), urinary tract infection (n=8), skin infections (n=8), in group II there were patients without complications. Results. A retrospective analysis showed that in the selected group of patients, 3.1% had purulent-septic complications. The average age of patients in group I was 61.4±11.5 years, in group II - 61.6±13.2 years (p>0.05). 47.3% of patients in group I had preoperative anemia, while in group II – only 5% (χ2 < 0.02). At the same time, the hemoglobin level before surgery in the first group was 117.3±3.4 g/l, and in the second – 136.3±8.6 g/l, p<0.001. It was also revealed that concomitant diabetes mellitus was observed in 52.6% of patients with purulent-septic complications, which was 5 times higher than in patients of group II (10.5%, χ2<0.04). Conclusion. Thus, a retrospective analysis showed that risk factors for the development of purulent-septic complications after total joint replacement were preoperative anemia, concomitant diabetes mellitus, and hyperglycemia above 7.5 mmol/l at the end of the operation.