The impact of systemic lupus erythematosus on the risk of infection after total hip arthroplasty: a nationwide population-based matched cohort study

Arthritis Research & Therapy

Shih-Chieh Shao¹  Chi-Chin Sun²  Dave W. Chen³  Chien-Hao Chen³  Tien-Hsing Chen⁴  Yu-Sheng Lin⁵  Liang-Tseng Kuo⁶ 

[1] Biostatistical Consultation Center of Chang Gung Memorial Hospital, Keelung, Taiwan;Department of Pharmacy, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan;School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan;Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan;Department of Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan;Department of Medical Research and Development, Chang Gung Memorial Hospital, Keelung, Taiwan;Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan;Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Keelung, Taiwan;Biostatistical Consultation Center of Chang Gung Memorial Hospital, Keelung, Taiwan;Division of Cardiology, Department of Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan;Division of Sports Medicine, Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan. No. 6 West Sec, Chia-Pu Road, Putz City, Chiayi, Taiwan;Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan;

关键词: Systemic lupus erythematosus;    Total hip arthroplasty;    Periprosthetic joint infection;   

DOI  :  10.1186/s13075-020-02300-1

来源: Springer

【 摘 要 】

BackgroundWe aimed to assess the impact of systemic lupus erythematosus (SLE) on the risk of infection after total hip arthroplasty (THA).MethodsWe identified patients undergoing primary THA (1996–2013) in Taiwan National Health Insurance Research Database (NHIRD). Patients were then divided into the SLE and control groups according to the diagnosis of SLE. We used 1:1 propensity score to match the control to the SLE group by age, sex, and comorbidities. The primary outcome was infection, including early and late superficial wound infection and periprosthetic joint infection (PJI). The secondary outcome was in-hospital complications.ResultsWe enrolled 325 patients in each group. In the primary outcome, the incidence of early superficial wound infection and PJI was comparable between the SLE and matched-control group. However, the incidence of late superficial wound infection and PJI in the SLE group was higher than that in matched-control group (11.4% vs. 5.5%, P = 0.01; 5.2% vs 2.2%, P = 0.04, respectively). Furthermore, the SLE group had a higher risk for late superficial wound infection and PJI (hazard ratio = 2.37, 95% confidence interval (CI) 1.35–4.16; HR = 2.74, 95% CI 1.14–6.64, respectively) than the matched-control. Complications other than infection and in-hospital mortality cannot be compared because of very low incidence.ConclusionsSLE is a risk factor for developing late superficial wound infection and PJI, but not for early postoperative complications following THA. Clinical presentations should be monitored to avoid misdiagnosis of PJI in SLE patients after THA.

【 授权许可】

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