title: Predicting Infections After Total Joint Arthroplasty Using a Prescription Based Comorbidity Measure.
abstract: This study evaluated the association and predictive ability of co-morbidities measured by RxRisk-V, Elixhauser and Charlson measures and post-total hip (THA) and total knee arthroplasties (TKA) infection. THAs and TKAs (2001-2012) were identified using the Australian Department of Veterans' Affairs data. Infections within 90 days post-surgery were the study endpoint. Co-morbidities were identified using pharmacy (RxRisk-V) and hospitalization history (Elixhauser, Charlson). Of the 11,848 THAs, 3.1% (N = 364) had infections and out of 18,972 TKAs 3.4% (N = 648). Comorbidity burden and specific conditions were associated with infection likelihood. RxRisk-V performed better than other measures, but none had high predictive ability and differences were small. The best performing infection prediction models resulted when a combination of conditions identified by all measures was used.
authors.affiliation: Quality Use of Medicines and Pharmacy Research Centre, Medicine and Devices Surveillance Centre of Research Excellence, Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia.
authors.forename: Maria C S
authors.initials: MC
authors.lastname: Inacio
authors.affiliation: Quality Use of Medicines and Pharmacy Research Centre, Medicine and Devices Surveillance Centre of Research Excellence, Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia.
authors.forename: Nicole L
authors.initials: NL
authors.lastname: Pratt
authors.affiliation: Quality Use of Medicines and Pharmacy Research Centre, Medicine and Devices Surveillance Centre of Research Excellence, Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia.
authors.forename: Elizabeth E
authors.initials: EE
authors.lastname: Roughead
authors.affiliation: Australian Orthopaedic Association, National Total Joint Replacement Registry, Level 6 Bice Building, Royal Adelaide Hospital, The University of Adelaide, Adelaide, SA, Australia.
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Graves
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D001315:Australia / Q000453:epidemiology; D015897:Comorbidity; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D016459:Prosthesis-Related Infections / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies
keywords: RxRisk-V; co-morbidities; pharmacy data; total hip arthroplasty; total knee arthroplasty