title: Risk factors for periprosthetic joint infection following primary total hip or knee arthroplasty: a meta-analysis.
abstract: To identify risk factors for periprosthetic joint infection following primary total joint arthroplasty, a systematic search was performed in Pubmed, Embase and Cochrane library databases. Pooled odds ratios (ORs) or standardised mean differences (SMDs) with 95% confidence intervals (CIs) were calculated. Patient characteristics, surgical-related factors and comorbidities, as potential risk factors, were investigated. The main factors associated with infection after total joint arthroplasty (TJA) were male gender (OR, 1·48; 95% CI, 1.19-1.85), age (SMD, -0·10; 95% CI, -0.17--0.03), obesity (OR, 1·54; 95% CI, 1·25-1·90), alcohol abuse (OR, 1·88; 95% CI, 1·32-2·68), American Society of Anesthesiologists (ASA) scale > 2 (OR, 2·06; 95% CI, 1·77-2·39), operative time (SMD, 0·49; 95% CI, 0·19-0·78), drain usage (OR, 0·36; 95% CI, 0·18-0·74), diabetes mellitus (OR, 1·58; 95% CI, 1·37-1·81), urinary tract infection (OR, 1·53; 95% CI, 1.09-2.16) and rheumatoid arthritis (OR, 1·57; 95% CI, 1·30-1·88). Among these risk factors, ASA score > 2 was a high risk factor, and drain usage was a protective factor. There was positive evidence for some factors that could be used to prevent the onset of infection after TJA.
authors.affiliation: Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Hebei, P.R. China.
authors.forename: Lingde
authors.initials: L
authors.lastname: Kong
authors.affiliation: Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Hebei, P.R. China.
authors.forename: Junming
authors.initials: J
authors.lastname: Cao
authors.affiliation: Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Hebei, P.R. China.
authors.forename: Yingze
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Hebei, P.R. China.
authors.forename: Wenyuan
authors.initials: W
authors.lastname: Ding
authors.affiliation: Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Hebei, P.R. China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Shen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery*; D016459:Prosthesis-Related Infections / Q000209:etiology* / Q000601:surgery*; D012086:Reoperation / Q000706:statistics & numerical data*; D012307:Risk Factors
keywords: Meta-analysis; Periprosthetic joint infection; Risk factor; Systematic review; Total joint arthroplasty