Publication
Title
Clinical outcome and risk factors for failure in late acute prosthetic joint infections treated with debridement and implant retention
Author
Institution/Organisation
ESCMID Study Grp Implant Associate
Abstract
Objectives: Debridement, antibiotics and implant retention (DAIR) is the recommended treatment for all acute prosthetic joint infections (PJI), but its efficacy in patients with late acute (LA) PJI is not well described. Methods: Patients diagnosed with LA PJI between 2005 and 2015 were retrospectively evaluated. LA PJI was defined as the development of acute symptoms (<= 3 weeks) occurring >= 3 months after arthroplasty. Failure was defined as: (i) the need for implant removal, (ii) infection related death, (iii) the need for suppressive antibiotic therapy and/or (iv) relapse or reinfection during follow-up. Results: 340 patients from 27 centers were included. The overall failure rate was 45.0% (153/340). Failure was dominated by Staphylococcus aureus PJI (54.7%, 76/139). Significant independent preoperative risk factors for failure according to the multivariate analysis were: fracture as indication for the prosthesis (odds ratio (OR) 5.4), rheumatoid arthritis (OR 5.1), age above 80 years (OR 2.6), male gender (OR 2.0) and C-reactive protein > 150 mg/L (OR 2.0). Exchanging the mobile components during DAIR was the strongest predictor for treatment success (OR 0.35). Conclusion: LA PJIs have a high failure rate. Treatment strategies should be individualized according to patient's age, comorbidity, clinical presentation and microorganism causing the infection. (C) 2018 The British Infection Association. Published by Elsevier Ltd. All rights reserved.
Language
English
Source (journal)
The journal of infection. - London
Publication
London : 2019
ISSN
0163-4453
DOI
10.1016/J.JINF.2018.07.014
Volume/pages
78 :1 (2019) , p. 40-47
ISI
000454534000006
Pubmed ID
30092305
Full text (Publisher's DOI)
Full text (open access)
Full text (publisher's version - intranet only)
UAntwerpen
Publication type
Subject
Affiliation
Publications with a UAntwerp address
External links
Web of Science
Record
Identifier
Creation 06.02.2019
Last edited 14.01.2025
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