title: Differences in the risk factors for surgical site infection between total hip arthroplasty and total knee arthroplasty in the Korean Nosocomial Infections Surveillance System (KONIS).
abstract: OBJECTIVE
  To compare the characteristics and risk factors for surgical site infections (SSIs) after total hip arthroplasty (THA) and total knee arthroplasty (TKA) in a nationwide survey, using shared case detection and recording systems.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Twenty-six hospitals participating in the Korean Nosocomial Infections Surveillance System (KONIS).
  
  
  METHODS
  From 2006 to 2009, all patients undergoing THA and TKA in KONIS were enrolled.
  
  
  RESULTS
  SSI occurred in 161 (2.35%) of 6,848 cases (3,422 THAs and 3,426 TKAs). Pooled mean SSI rates were 1.69% and 2.82% for THA and TKA, respectively. Of the cases we examined, 42 (26%) were superficial-incisional SSIs and 119 (74%) were "severe" SSIs; of the latter, 24 (15%) were deep-incisional SSIs and 95 (59%) were organ/space SSIs. In multivariate analysis, a duration of preoperative hospital stay of greater than 3 days was a risk factor for total SSI after both THA and TKA. Diabetes mellitus, revision surgery, prolonged duration of surgery (above the 75th percentile), and the need for surgery due to trauma were independent risk factors for total and severe SSI after THA, while male sex and an operating room without artificial ventilation were independent risk factors for total and severe SSI after TKA. A large volume of surgeries (more than 10 procedures per month) protected against total and severe SSI, but only in patients who underwent TKA.
  
  
  CONCLUSIONS
  Risk factors for SSI after arthroplasty differ according to the site of the arthroplasty. Therefore, clinicians should take into account the site of arthroplasty in the analysis of SSI and the development of strategies for reducing SSI.
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors.forename: Kyoung-Ho
authors.initials: KH
authors.lastname: Song
authors.forename: Eu Suk
authors.initials: ES
authors.lastname: Kim
authors.forename: Young Keun
authors.initials: YK
authors.lastname: Kim
authors.forename: Hye Young
authors.initials: HY
authors.lastname: Jin
authors.forename: Sun Young
authors.initials: SY
authors.lastname: Jeong
authors.forename: Yee Gyung
authors.initials: YG
authors.lastname: Kwak
authors.forename: Yong Kyun
authors.initials: YK
authors.lastname: Cho
authors.forename: Joohon
authors.initials: J
authors.lastname: Sung
authors.forename: Yeong-Seon
authors.initials: YS
authors.lastname: Lee
authors.forename: Hee-Bok
authors.initials: HB
authors.lastname: Oh
authors.forename: Tae Kyun
authors.initials: TK
authors.lastname: Kim
authors.forename: Kyung-Hoi
authors.initials: KH
authors.lastname: Koo
authors.forename: Eui-Chong
authors.initials: EC
authors.lastname: Kim
authors.forename: June Myung
authors.initials: JM
authors.lastname: Kim
authors.forename: Tae Yeol
authors.initials: TY
authors.lastname: Choi
authors.forename: Hyo Youl
authors.initials: HY
authors.lastname: Kim
authors.forename: Hee Jung
authors.initials: HJ
authors.lastname: Choi
authors.forename: Hong Bin
authors.initials: HB
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D003428:Cross Infection / Q000453:epidemiology / Q000209:etiology; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011159:Population Surveillance; D011183:Postoperative Complications / Q000209:etiology*; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology*; D055815:Young Adult