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Prevalence of modifiable risk factors in primary elective arthroplasty and their association with infections

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dc.contributor.author Sigurðardóttir, María
dc.contributor.author Sigurðsson, Martin Ingi
dc.contributor.author Ólafsson, Yngvi
dc.contributor.author Sverrisdóttir, Sólveig Hólmfr
dc.contributor.author Gunnarsdóttir, Ingibjörg
dc.contributor.author Sigurðsson, Emil Lárus
dc.contributor.author Kárason, Sigurbergur
dc.date.accessioned 2023-04-27T01:03:54Z
dc.date.available 2023-04-27T01:03:54Z
dc.date.issued 2023-02-02
dc.identifier.citation Sigurðardóttir , M , Sigurðsson , M I , Ólafsson , Y , Sverrisdóttir , S H , Gunnarsdóttir , I , Sigurðsson , E L & Kárason , S 2023 , ' Prevalence of modifiable risk factors in primary elective arthroplasty and their association with infections ' , Acta Orthopaedica , vol. 94 , pp. 38-44 . https://doi.org/10.2340/17453674.2023.8480
dc.identifier.issn 1745-3674
dc.identifier.other PURE: 90961148
dc.identifier.other PURE UUID: c994e126-43b2-4dd7-b7a7-82e953124890
dc.identifier.other Scopus: 85147573136
dc.identifier.other unpaywall: 10.2340/17453674.2023.8480
dc.identifier.uri https://hdl.handle.net/20.500.11815/4175
dc.description Funding Information: The study was approved by the Science Committee of the Capital area’s Primary Care and University of Iceland and by the Icelandic National Bioethics Committee (case number: VSN-18-098) and is registered at ClinicalTrials. gov (NCT05399186). This study was supported by grants from Landspitali Research Fund (A-2019-056, A-202-042, A-2021-036) and Research fund of Sigridur Larusdottir by University of Iceland. Data sharing is possible after reasonable request. The authors declare no conflict of interest. Completed disclosure forms for this article following the ICMJE template are available on the article page, doi: 10.2340/17453674.2023.8480 Publisher Copyright: © 2023 The Author(s).
dc.description.abstract Background and purpose — The aim of this study was to identify the prevalence of modifiable risk factors of surgical site infections (SSI) in patients undergoing primary elective total joint arthroplasty (TJA) receiving conventional preoperative preparation, and to explore their association with infectious outcomes. Patients and methods — Information regarding modifiable risk factors (anemia, diabetes, obesity, nutritional status, smoking, physical activity) was prospectively gath-ered in patients undergoing primary TJA of hip or knee in 2018–2020 at a single institution with 6 weeks’ follow-up time. Results — 738 patients (median age 68 years [IQR 61–73], women 57%) underwent TJA (knee 64%, hip 36%). Anemia was detected in 8%, diabetes was present in 9%, an additional 2% had undiagnosed diabetes (HbA1c > 47 mmol/mol), and 8% dysglycemia (HbA1c 42–47 mmol/mol). Obesity (BMI ≥ 30) was observed in 52%. Serum albumin, total lymphocyte count, and vitamin D below normal limits was identified in 0.1%, 18%, and 16%, respectively. Current smokers were 7%. Surgical site complications occurred in 116 (16%), superficial SSI in 57 (8%), progressing to periprosthetic joint infection in 7 cases. Univariate analysis identified higher odds of superficial SSI for BMI ≥ 30 (OR 2.1, 95%CI 1.2–3.8) and HbA1c ≥ 42 mmol/mol (OR 2.2, CI 1.1–4.2), but no association was found with other factors. Conclusion — In a general population undergoing primary TJA an association was found between obesity (52%) and dysglycemia/diabetes (19%) and superficial SSI (8%), which progressed to PJI in 12% of cases, generating a 1% total rate of PJI. Modification of these risk factors might mitigate infectious adverse outcomes.
dc.format.extent 7
dc.format.extent 38-44
dc.language.iso en
dc.relation.ispartofseries Acta Orthopaedica; 94()
dc.rights info:eu-repo/semantics/openAccess
dc.subject Svæfinga- og gjörgæslulæknisfræði
dc.subject Bæklunarskurðlæknisfræði
dc.subject Næringarfræðingar
dc.subject Aged
dc.subject Female
dc.subject Humans
dc.subject Arthroplasty, Replacement, Hip/adverse effects
dc.subject Arthroplasty, Replacement, Knee/adverse effects
dc.subject Glycated Hemoglobin
dc.subject Obesity/complications
dc.subject Prevalence
dc.subject Prosthesis-Related Infections/epidemiology
dc.subject Retrospective Studies
dc.subject Risk Factors
dc.subject Male
dc.subject Middle Aged
dc.subject Medicine (all)
dc.subject Surgery
dc.title Prevalence of modifiable risk factors in primary elective arthroplasty and their association with infections
dc.type /dk/atira/pure/researchoutput/researchoutputtypes/contributiontojournal/article
dc.description.version Peer reviewed
dc.identifier.pmid 36727913
dc.identifier.doi https://doi.org/10.2340/17453674.2023.8480
dc.relation.url http://www.scopus.com/inward/record.url?scp=85147573136&partnerID=8YFLogxK
dc.contributor.department Other departments
dc.contributor.department Faculty of Medicine
dc.contributor.department Surgical Services
dc.contributor.department Faculty of Food Science and Nutrition

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