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

Research output: Contribution to journalArticle

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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 1

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Surgical Wound Infection
Knee Replacement Arthroplasties
Cross Infection
Arthroplasty
Hip
Tacrine
Operating Rooms
Reoperation

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Song, Kyoung Ho ; Kim, Eu Suk ; Kim, Young Keun ; Jin, Hye Young ; Jeong, Sun Young ; Kwak, Yee Gyung ; Cho, Yong Kyun ; Sung, Joohon ; Lee, Yeong Seon ; Oh, Hee Bok ; Kim, Tae Kyun ; Koo, Kyung Hoi ; Kim, Eui Chong ; Kim, June Myung ; Choi, Tae Yeol ; Kim, Hyo Youl ; Choi, Hee Jung ; Kim, Hong Bin. / 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). In: Infection Control and Hospital Epidemiology. 2012 ; Vol. 33, No. 11. pp. 1086-1093.
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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.",
author = "Song, {Kyoung Ho} and Kim, {Eu Suk} and Kim, {Young Keun} and Jin, {Hye Young} and Jeong, {Sun Young} and Kwak, {Yee Gyung} and Cho, {Yong Kyun} and Joohon Sung and Lee, {Yeong Seon} and Oh, {Hee Bok} and Kim, {Tae Kyun} and Koo, {Kyung Hoi} and Kim, {Eui Chong} and Kim, {June Myung} and Choi, {Tae Yeol} and Kim, {Hyo Youl} and Choi, {Hee Jung} and Kim, {Hong Bin}",
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Song, KH, Kim, ES, Kim, YK, Jin, HY, Jeong, SY, Kwak, YG, Cho, YK, Sung, J, Lee, YS, Oh, HB, Kim, TK, Koo, KH, Kim, EC, Kim, JM, Choi, TY, Kim, HY, Choi, HJ & Kim, HB 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, vol. 33, no. 11, pp. 1086-1093. https://doi.org/10.1086/668020

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). / Song, Kyoung Ho; Kim, Eu Suk; Kim, Young Keun; Jin, Hye Young; Jeong, Sun Young; Kwak, Yee Gyung; Cho, Yong Kyun; Sung, Joohon; Lee, Yeong Seon; Oh, Hee Bok; Kim, Tae Kyun; Koo, Kyung Hoi; Kim, Eui Chong; Kim, June Myung; Choi, Tae Yeol; Kim, Hyo Youl; Choi, Hee Jung; Kim, Hong Bin.

In: Infection Control and Hospital Epidemiology, Vol. 33, No. 11, 01.11.2012, p. 1086-1093.

Research output: Contribution to journalArticle

TY - JOUR

T1 - 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)

AU - Song, Kyoung Ho

AU - Kim, Eu Suk

AU - Kim, Young Keun

AU - Jin, Hye Young

AU - Jeong, Sun Young

AU - Kwak, Yee Gyung

AU - Cho, Yong Kyun

AU - Sung, Joohon

AU - Lee, Yeong Seon

AU - Oh, Hee Bok

AU - Kim, Tae Kyun

AU - Koo, Kyung Hoi

AU - Kim, Eui Chong

AU - Kim, June Myung

AU - Choi, Tae Yeol

AU - Kim, Hyo Youl

AU - Choi, Hee Jung

AU - Kim, Hong Bin

PY - 2012/11/1

Y1 - 2012/11/1

N2 - 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.

AB - 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.

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