title: Risk factors for periprosthetic infection after reverse shoulder arthroplasty.
abstract: BACKGROUND
  Management of periprosthetic infection after reverse shoulder arthroplasty (RSA) remains a challenge. Whereas the infection rate after RSA has improved, more information would be helpful to identify patient risk factors for infection after RSA. The purpose of this study was to evaluate risk factors for infection after RSA.
  
  
  METHODS
  We identified 301 primary RSAs with a minimum of 1-year follow-up in a prospectively collected shoulder arthroplasty registry. We performed bivariate and multivariable logistic regression analyses to assess the association between patient demographic and clinical characteristics (age, sex, smoking, diabetes, rheumatoid arthritis, body mass index, and history of prior failed hemiarthroplasty or total shoulder arthroplasty) and periprosthetic infection after RSA.
  
  
  RESULTS
  There were 15 periprosthetic infections after RSA (5.0%). Patients with a history of RSA for failed arthroplasty (odds ratio, 5.75; 95% confidence interval, 2.01-16.43; P = .001) and patients younger than 65 years had an increased risk for development of an infection (odds ratio, 4.0; 95% confidence interval, 1.21-15.35; P = .021). History of smoking, diabetes, rheumatoid arthritis, or obesity did not contribute to an increased risk of infection after RSA.
  
  
  CONCLUSIONS
  This is the first study evaluating risk factors for infection after RSA while controlling for confounding variables with multivariable analysis. The greatest risk factors for infection after RSA were history of a prior failed arthroplasty and age younger than 65 years. Patients with these clinical characteristics should be counseled preoperatively about the increased risk for development of infection after RSA.
authors.affiliation: Fondren Orthopedic Group, Texas Orthopedic Hospital, Houston, TX, USA. Electronic address: brent.joseph.morris@gmail.com.
authors.forename: Brent J
authors.initials: BJ
authors.lastname: Morris
authors.affiliation: Laboratory of Integrated Physiology, University of Houston, Houston, TX, USA.
authors.forename: Daniel P
authors.initials: DP
authors.lastname: O'Connor
authors.affiliation: Department of Orthopaedic Surgery and Rehabilitation, University of Texas Medical Branch, Galveston, TX, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Torres
authors.affiliation: Fondren Orthopedic Group, Texas Orthopedic Hospital, Houston, TX, USA.
authors.forename: Hussein A
authors.initials: HA
authors.lastname: Elkousy
authors.affiliation: Fondren Orthopedic Group, Texas Orthopedic Hospital, Houston, TX, USA.
authors.forename: Gary M
authors.initials: GM
authors.lastname: Gartsman
authors.affiliation: Fondren Orthopedic Group, Texas Orthopedic Hospital, Houston, TX, USA.
authors.forename: T Bradley
authors.initials: TB
authors.lastname: Edwards
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement / Q000009:adverse effects*; D005260:Female; D062785:Hemiarthroplasty; D006801:Humans; D007595:Joint Prosthesis / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D016459:Prosthesis-Related Infections / Q000209:etiology* / Q000382:microbiology; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D012785:Shoulder Joint / Q000601:surgery*; D017211:Treatment Failure; D055815:Young Adult
keywords: Infection; reverse shoulder arthroplasty