AIM To research the influence of season of the year on periprosthetic joint infections.METHODS We conducted a retrospective review of the entire Medicare files from 2005 to 2014. Seasons were classified as spring, sum...AIM To research the influence of season of the year on periprosthetic joint infections.METHODS We conducted a retrospective review of the entire Medicare files from 2005 to 2014. Seasons were classified as spring, summer, fall or winter. Regional variations were accounted for by dividing patients into four geographic regions as per the United States Census Bureau(Northeast, Midwest, West and South). Acute postoperative infection and deep periprosthetic infections within 90 d after surgery were tracked. RESULTS In all regions, winter had the highest incidence of periprosthetic infections(mean 0.98%, SD 0.1%) and was significantly higher than other seasons in the Midwest, South and West(P < 0.05 for all) but not the Northeast(P = 0.358). Acute postoperative infection rates were more frequent in the summer and were significantly affected by season of the year in the West.CONCLUSION Season of the year is a risk factor for periprosthetic joint infection following total hip arthroplasty(THA). Understanding the influence of season on outcomes following THA is essential when risk-stratifying patients to optimize outcomes and reduce episode of care costs.展开更多
BACKGROUND The influence of opioid use disorder on implant related complications, infection and readmission rates, and total global episode-of-care costs following primary total knee arthroplasty(TKA) is limited.AIM T...BACKGROUND The influence of opioid use disorder on implant related complications, infection and readmission rates, and total global episode-of-care costs following primary total knee arthroplasty(TKA) is limited.AIM To examine whether opioid abuse in patients undergoing primary TKA.METHODS A retrospective analysis of the Medicare dataset, using the PearlDiver database,from 2005-2014 comparing outcomes in patients with opioid abusers(OUD) to non-opioid abusers(NOU) undergoing primary TKA was performed. Patient outcomes were analyzed including implant complications, readmission rates, and day-of-surgery and 90-d cost. Statistical analysis was performed with R(University of Auckland, New Zealand) calculating odds-ratio(OR) along with their respective 95% confidence interval(95%CI) and P-values.RESULTS The OUD group was at greater odds of having implant related complications overall(20.84% vs 11.25%; OR: 2.07; 95%CI: 1.93-2.23; P < 0.001). Revision(OR:2.07; 95%CI: 1.11-3.84; P < 0.001), infection(OR: 1.92; 95%CI: 1.72–2.18; P < 0.001),periprosthetic fractures(OR: 1.83; 95%CI: 1.16-4.79; P < 0.001), and 90-dreadmission rates(OR: 1.47, 95%CI: 1.35-1.61, P < 0.001) were also significantly increased. OUD patients also incurred in higher day-of-surgery and total global 90-d episode-of-care costs compared to NOU.CONCLUSION Patients with OUD show an increased risk of complications compared to the nonopioid users group. Appropriate recognition, pre-surgical optimization, and patient education are essential to mitigate these complications and improve patient outcome.展开更多
文摘AIM To research the influence of season of the year on periprosthetic joint infections.METHODS We conducted a retrospective review of the entire Medicare files from 2005 to 2014. Seasons were classified as spring, summer, fall or winter. Regional variations were accounted for by dividing patients into four geographic regions as per the United States Census Bureau(Northeast, Midwest, West and South). Acute postoperative infection and deep periprosthetic infections within 90 d after surgery were tracked. RESULTS In all regions, winter had the highest incidence of periprosthetic infections(mean 0.98%, SD 0.1%) and was significantly higher than other seasons in the Midwest, South and West(P < 0.05 for all) but not the Northeast(P = 0.358). Acute postoperative infection rates were more frequent in the summer and were significantly affected by season of the year in the West.CONCLUSION Season of the year is a risk factor for periprosthetic joint infection following total hip arthroplasty(THA). Understanding the influence of season on outcomes following THA is essential when risk-stratifying patients to optimize outcomes and reduce episode of care costs.
文摘BACKGROUND The influence of opioid use disorder on implant related complications, infection and readmission rates, and total global episode-of-care costs following primary total knee arthroplasty(TKA) is limited.AIM To examine whether opioid abuse in patients undergoing primary TKA.METHODS A retrospective analysis of the Medicare dataset, using the PearlDiver database,from 2005-2014 comparing outcomes in patients with opioid abusers(OUD) to non-opioid abusers(NOU) undergoing primary TKA was performed. Patient outcomes were analyzed including implant complications, readmission rates, and day-of-surgery and 90-d cost. Statistical analysis was performed with R(University of Auckland, New Zealand) calculating odds-ratio(OR) along with their respective 95% confidence interval(95%CI) and P-values.RESULTS The OUD group was at greater odds of having implant related complications overall(20.84% vs 11.25%; OR: 2.07; 95%CI: 1.93-2.23; P < 0.001). Revision(OR:2.07; 95%CI: 1.11-3.84; P < 0.001), infection(OR: 1.92; 95%CI: 1.72–2.18; P < 0.001),periprosthetic fractures(OR: 1.83; 95%CI: 1.16-4.79; P < 0.001), and 90-dreadmission rates(OR: 1.47, 95%CI: 1.35-1.61, P < 0.001) were also significantly increased. OUD patients also incurred in higher day-of-surgery and total global 90-d episode-of-care costs compared to NOU.CONCLUSION Patients with OUD show an increased risk of complications compared to the nonopioid users group. Appropriate recognition, pre-surgical optimization, and patient education are essential to mitigate these complications and improve patient outcome.
