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)

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, Hee Bok Oh, Tae Kyun Kim, Kyung Hoi Koo, Eui Chong Kim, June Myung Kim, Tae Yeol Choi, Hyo Youl Kim, Hee Jung Choi, Hong Bin Kim

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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.

Original languageEnglish
Pages (from-to)1086-1093
Number of pages8
JournalInfection Control and Hospital Epidemiology
Volume33
Issue number11
DOIs
Publication statusPublished - 2012 Nov

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases

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    Song, K. H., Kim, E. S., Kim, Y. K., Jin, H. Y., Jeong, S. Y., Kwak, Y. G., Cho, Y. K., Sung, J., Lee, Y. S., Oh, H. B., Kim, T. K., Koo, K. H., Kim, E. C., Kim, J. M., Choi, T. Y., Kim, H. Y., Choi, H. J., & Kim, H. B. (2012). 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). Infection Control and Hospital Epidemiology, 33(11), 1086-1093. https://doi.org/10.1086/668020