Hospital-Acquired Conditions: A Review of Classical and Novel Risk Factors Following Total Hip and Knee Arthroplasties.

Zachary Crespi, Aya Ismail, Mohamed E Awad, Ahmad I Hasan, Furqan B Irfan, Muhammad Jaffar, Mouhanad M El-Othmani, Khaled J Saleh

Journal: JBJS reviews 2022;9(7):

PMID: 34270501

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Abstract

In 2016, a total of 48,771 hospital-acquired conditions (HACs) were reported in U.S. hospitals. These incidents resulted in an excess cost of >$2 billion, which translates to roughly $41,000 per patient per HAC.

In the settings of total hip arthroplasty (THA) and total knee arthroplasty (TKA), increased age, a body mass index of >35 kg/m2, male sex, diabetes mellitus, electrolyte disturbances, and a history of anemia increase the likelihood of surgical site infections.

Institution-specific (surgical) risk factors such as increased tourniquet time, an operative time of >130 minutes, bilateral procedures, a femoral nerve block, and general anesthesia increase the risk of HACs in the settings of THA and TKA.

Address: Central Michigan University College of Medicine, Mount Pleasant, Michigan.; University of Michigan, Dearborn, Michigan.; FAJR Scientific, Northville, Michigan.; Saleh Medical Innovations Consulting, PLLC, Northville, Michigan.; NorthStar Anesthesia, Detroit Medical Center, Detroit, Michigan.; Michigan State University, College of Osteopathic Medicine, Detroit, Michigan.; Wayne State University School of Medicine, Detroit, Michigan.; Department of Orthopedic Surgery, Detroit Medical Center, Detroit, Michigan.

DOI: 10.2106/JBJS.RVW.20.00240

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MeSH Terms: Arthroplasty, Replacement, Hip, Arthroplasty, Replacement, Knee, Hospitals, Humans, Male, Risk Factors, Surgical Wound Infection