Incidence and risk factors of 30-day surgical site infection after primary total joint arthroplasty in a middle-income country: A single-center experience

Vuk Marusic, Ljiljana Markovic-Denic, Olivera Djuric, Andja Cirkovic, Vladimir Nikolic, Emilija Dubljanin-Raspopovic, Marko Kadija

Research output: Contribution to journalArticlepeer-review

Abstract

The data about the incidence and risk factors for surgical site infections (SSIs) following total joint arthroplasty (TJA) in middle-income countries are still scant. The aim of this study was to assess the incidence and risk factors associated with 30-day SSIs following total hip arthroplasty (THA) and total knee arthroplasty (TKA). The study was conducted at the Clinic for Orthopedic Surgery and Traumatology, Clinical Center of Serbia (CCS) in Belgrade, from May 2016 to April 2018. All patients undergoing THA or TKA were followed throughout hospitalization until day 30 after discharge. Of the 1073 admitted patients, 459 had THA and 230 had TKA. The incidence rate of surgical site infections (SSIs) among the patients who underwent THA was 5.4%, which is 3.8 per 1000 postoperative patient-days, while the rate among those who had TKA was 4.8%, i.e., 3.4 per 1000 postoperative patient-days. Out of the 36 SSIs, 15 were deep and 21 were superficial incisional ones. Among the variables examined, the independent risk factors for SSIs after THA were the American Society of Anesthesiologists (ASA) score > 2 (RR = 3.17; 95% CI—1.26–8.02), smoking (RR = 3.14; 95% CI—1.26–7.82) and peripheral vascular disease (PVD) (RR = 6.09; 95% CI—2.35–15.77), and after TKA, only PVD (RR = 3.87; 95% CI—1.09–13.76) was the risk factor. Incidence rates of SSIs after arthroplasty are higher compared to reports from developed countries. Therefore, it is necessary to enhance infection prevention and control measures with strict control of modifiable risk factors.

Original languageEnglish
Article number863
Pages (from-to)1-11
Number of pages11
JournalInternational Journal of Environmental Research and Public Health
Volume18
Issue number3
DOIs
Publication statusPublished - Feb 1 2021
Externally publishedYes

Keywords

  • Prospective cohort study
  • Risk factors
  • Surgical site infection
  • Total hip arthroplasty
  • Total knee arthroplasty

ASJC Scopus subject areas

  • Pollution
  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis

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