Risk factors for septic arthritis in patients with joint disease. A prospective study.
OBJECTIVE
To quantify potential risk factors for septic arthritis, in order to identify a basis for prevention.


METHODS
The occurrence of potential risk factors for septic arthritis in patients with joint diseases attending a rheumatic disease clinic was prospectively monitored at 3-month intervals over a period of 3 years. Potential risk factors investigated were type of joint disease, comorbidity, medication, joint prosthesis, infections, and invasive procedures. The frequencies of risk factors in patients with and those without septic arthritis were compared using multiple logistic regression analysis.


RESULTS
There were 37 patients with and 4,870 without septic arthritis. Risk factors for developing septic arthritis were age > or = 80 years (odds ratio [OR] = 3.5, 95% confidence interval [95% CI] 1.4-8.6), diabetes mellitus (OR = 3.3, 95% CI 1.1-10.1), rheumatoid arthritis (OR = 4.0, 95% CI 1.9-8.3), hip and/or knee prosthesis (OR = 15, 95% CI 4.1-54.3), joint surgery (OR = 5.1, 95% CI 2.2-11.9), and skin infection (OR = 27.2, 95% CI 7.6-97.1).


CONCLUSIONS
These findings indicate that preventive measures against septic arthritis in patients with joint diseases should mainly be directed at those with joint prostheses and/or skin infection.
Kaandorp
C J
CJ
Jan van Breemen Institute for Rheumatology and Rehabilitation, Amsterdam, The Netherlands.
Van Schaardenburg
D
D
Krijnen
P
P
Habbema
J D
JD
van de Laar
M A
MA
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001170:Arthritis, Infectious / Q000150:complications / Q000453:epidemiology*; D001172:Arthritis, Rheumatoid / Q000150:complications; D048909:Diabetes Complications; D005260:Female; D006801:Humans; D015994:Incidence; D007592:Joint Diseases / Q000150:complications*; D007595:Joint Prosthesis / Q000009:adverse effects; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009426:Netherlands / Q000453:epidemiology; D016017:Odds Ratio; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012874:Skin Diseases, Infectious / Q000150:complications