Scoring system may identify patients at risk for SSI after arthroplasty
Scoring system may identify patients at risk for SSI after arthroplasty[*]July 31, 2012
Researchers from the Mayo Clinic have developed a prognostic scoring system to determine the risk for prosthetic joint infection among patients undergoing total hip or total knee arthroplasty.
Data from a previous single-center, prospective case-control study conducted from 2001 to 2006 were used to develop the scoring system. Case patients were those who developed an infection after arthroplasty and control patients without infection were matched. Forms were used to interview patients and abstract data from medical records.The study included 617 patients with complete data.
There were two different scores: The Mayo prosthetic joint infection (PJI) risk score assessed at baseline and the 1-month postsurgery Mayo PJI risk score. The baseline risk score included variables from the preoperative and operative periods. The 1-month score included preoperative, operative and postoperative variables.
Factors found to be associated with the baseline risk score were BMI, prior operation on the joint, prior arthroplasty, immunosuppression, American Society of Anesthesiologists (ASA) score and procedure duration. The 1-month score included the same variables, as well as postoperative wound drainage.
“Once validated, these courses could serve as a useful guide for health policy and risk stratification reporting,” the researchers wrote. “There is an appropriate drive for minimizing the risk of surgical site infections and there has been a recent push toward withholding payment for the treatment of this ‘preventable’ complication. The use of the baseline score would allow better risk stratification and comparison of surgical site infection rates among institutions in the future.”
References:
Berbari EF. Infect Control Hosp Epidemiol. 2012;33:774-781.
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