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Differences in the Risk Factors for Surgical Site Infection between Total Hip Arthroplasty and Total Knee Arthroplasty in the Korean Nosocomial Infections Surveillance System (KONIS)

Published online by Cambridge University Press:  02 January 2015

Kyoung-Ho Song ,
Eu Suk Kim ,
Young Keun Kim ,
Hye Young Jin ,
Sun Young Jeong ,
Yee Gyung Kwak ,
Yong Kyun Cho ,
Joohon Sung ,
Yeong-Seon Lee  and
Hee-Bok Oh
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Kyoung-Ho Song
Affiliation:
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
Eu Suk Kim
Affiliation:
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
Young Keun Kim
Affiliation:
Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
Hye Young Jin
Affiliation:
Infection Control Office, Ajou University Hospital, Suwon, Republic of Korea
Sun Young Jeong
Affiliation:
Infection Control Office, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea
Yee Gyung Kwak
Affiliation:
Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea
Joohon Sung
Affiliation:
Department of Epidemiology and Institute of Environment and Health, Seoul National University School of Public Health, Seoul, Republic of Korea
Yeong-Seon Lee
Affiliation:
Center for Infectious Diseases, Korea National Institute of Health, Osong, Republic of Korea
Hee-Bok Oh
Affiliation:
Center for Infectious Diseases, Korea National Institute of Health, Osong, Republic of Korea
Tae Kyun Kim
Affiliation:
Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
Kyung-Hoi Koo
Affiliation:
Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
Eui-Chong Kim
Affiliation:
Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
June Myung Kim
Affiliation:
Division of Infectious Diseases, Yonsei Medical Center, Seoul, Republic of Korea
Tae Yeol Choi
Affiliation:
Department of Laboratory Medicine, Hanyang University Hospital, Seoul, Republic of Korea
Hyo Youl Kim
Affiliation:
Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
Hee Jung Choi
Affiliation:
Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Republic of Korea.
Hong Bin Kim*
Affiliation:
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
*
Department of Internal Medicine, Seoul National University Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam, Republic of Korea, 463-707 (hbkimmd@snu.ac.kr)
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Abstract

Objective.

To compare the characteristics and risk factors for surgical site infections (SSIs) after total hip arthroplasty (THA) and total knee arthroplasty (TKA) in a nationwide survey, using shared case detection and recording systems.

Design.

Retrospective cohort study.

Setting.

Twenty-six hospitals participating in the Korean Nosocomial Infections Surveillance System (KONIS).

Patients.

From 2006 to 2009, all patients undergoing THA and TKA in KONIS were enrolled.

Results.

SSI occurred in 161 (2.35%) of 6,848 cases (3,422 THAs and 3,426 TKAs). Pooled mean SSI rates were 1.69% and 2.82% for THA and TKA, respectively. Of the cases we examined, 42 (26%) were superficial-incisional SSIs and 119 (74%) were “severe” SSIs; of the latter, 24 (15%) were deep-incisional SSIs and 95 (59%) were organ/space SSIs. In multivariate analysis, a duration of preoperative hospital stay of greater than 3 days was a risk factor for total SSI after both THA and TKA. Diabetes mellitus, revision surgery, prolonged duration of surgery (above the 75th percentile), and the need for surgery due to trauma were independent risk factors for total and severe SSI after THA, while male sex and an operating room without artificial ventilation were independent risk factors for total and severe SSI after TKA. A large volume of surgeries (more than 10 procedures per month) protected against total and severe SSI, but only in patients who underwent TKA.

Conclusions.

Risk factors for SSI after arthroplasty differ according to the site of the arthroplasty. Therefore, clinicians should take into account the site of arthroplasty in the analysis of SSI and the development of strategies for reducing SSI.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 33 , Issue 11 , November 2012 , pp. 1086 - 1093
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2012

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