title: Same-Day Surgery Does Not Increase Deep Infection Risk in Bilateral Total Hip Arthroplasty Patients.
abstract: Patients with bilateral hip disease may undergo same-day or staged bilateral total hip arthroplasty (THA). Our purpose was to compare the odds and identify risk factors for deep periprosthetic joint infection (PJI) among patients undergoing same-day vs staged bilateral THA (within 1 year or more than 1 year apart).
  
  
  
  Administrative data for patients subjected to same-day and staged bilateral THA between January 1999 and December 2013 were retrieved. Patients with subsequent PJI were identified. Mean follow-up was 112.6 months (range, 23-201). A logistic regression model was constructed to determine differences in odds for infection between groups and risk factors for PJI.
  
  
  
  We identified 1808 patients treated with same-day bilateral THA, 2082 patients treated with staged THAs within 1 year, and 2760 patients treated with staged THAs more than 1 year apart. Patients treated with same-day procedures had similar odds for PJI compared to those treated with staged THAs within 1 year (odds ratio [OR] = 0.632, 95% confidence interval [CI] [0.203, 1.962]), or more than 1 year apart (OR = 1.391, 95% CI [0.516, 3.746]). Women had 66.1% lower odds for PJI than men (OR = 0.339, 95% CI [0.16, 0.72]). Patients with inflammatory arthritis had 632% higher odds for PJI than patients with degenerative arthritis (OR = 7.321, 95% CI [1.912, 28.028]). Allogeneic transfusion was associated with 166% higher odds for PJI (OR = 2.661, 95% CI [1.198, 5.911]).
  
  
  
  Same-day bilateral THA is not associated with increased odds for PJI compared to staged procedures. Male gender, inflammatory etiology, and allogeneic transfusion are significant risk factors for PJI in patients undergoing same-day or staged bilateral THA.
authors.affiliation: Department of Orthopaedic Surgery, Division of Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, New York.
authors.forename: Georgios K
authors.initials: GK
authors.lastname: Triantafyllopoulos
authors.affiliation: Department of Anesthesiology, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, New York.
authors.forename: Stavros G
authors.initials: SG
authors.lastname: Memtsoudis
authors.affiliation: Epidemiology and Biostatistics Core, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, New York.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Epidemiology and Biostatistics Core, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, New York.
authors.forename: Yan
authors.initials: Y
authors.lastname: Ma
authors.affiliation: Department of Orthopaedic Surgery, Division of Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, New York.
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Sculco
authors.affiliation: Department of Orthopaedic Surgery, Division of Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, New York.
authors.forename: Lazaros A
authors.initials: LA
authors.lastname: Poultsides
mesh_terms: D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures; D001170:Arthritis, Infectious / Q000209:etiology*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D016459:Prosthesis-Related Infections / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors
keywords: bilateral; infection; risk factors; same-day; staged; total hip arthroplasty