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The Mayo Prosthetic Joint Infection Risk Score: Implication for Surgical Site Infection Reporting and Risk Stratification

Published online by Cambridge University Press:  02 January 2015

Elie F. Berbari*
Affiliation:
Department of Medicine, Division of Infectious Diseases, Section of Orthopedic Infections, Mayo Clinic, Rochester, Minnesota Department of Infection Practice and Control, Mayo Clinic College of Medicine, Rochester, Minnesota
Douglas R. Osmon
Affiliation:
Department of Medicine, Division of Infectious Diseases, Section of Orthopedic Infections, Mayo Clinic, Rochester, Minnesota
Brian Lahr
Affiliation:
Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota
Jeanette E. Eckel-Passow
Affiliation:
Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota
Geoffrey Tsaras
Affiliation:
Department of Medicine, Division of Infectious Diseases, Section of Orthopedic Infections, Mayo Clinic, Rochester, Minnesota Present affiliation: Rockford Infectious Disease Consultants, Rockford, Illinois
Arlen D. Hanssen
Affiliation:
Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
Tad Mabry
Affiliation:
Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
James Steckelberg
Affiliation:
Department of Medicine, Division of Infectious Diseases, Section of Orthopedic Infections, Mayo Clinic, Rochester, Minnesota
Rodney Thompson
Affiliation:
Department of Infection Practice and Control, Mayo Clinic College of Medicine, Rochester, Minnesota
*
Division of Infectious Diseases, Mayo Clinic, 200 First SW, Rochester, MN 55905 (berbari.elie@mayo.edu)

Abstract

Objective.

The goal of this study was to develop a prognostic scoring system for the development of prosthetic joint infection (PJI) that could risk-stratify patients undergoing total hip (THA) or total knee (TKA) arthroplasties.

Design.

Previously reported case-control study.

Setting.

Tertiary referral care setting from 2001 through 2006.

Methods.

A derivation data set of 339 cases and 339 controls was used to develop 2 scores. A baseline score and a 1-month-postsurgery risk score were computed as a function of the relative contributions of risk factors for each model. Points were assigned for the presence of each factor and then summed to get a subject's risk score.

Results.

The following risk factors were detected from multivariable modeling and incorporated into the baseline Mayo PJI risk score: body mass index, prior other operation on the index joint, prior arthroplasty, immunosuppression, ASA score, and procedure duration (c index, 0.722). The 1-month-postsurgery risk score contained the same variables in addition to postoperative wound drainage (c index, 0.716).

Conclusion.

The baseline score might help with risk stratification in relation to public reporting and reimbursement as well as targeted prevention strategies in patients undergoing THA or TKA. The application of the 1-month-postsurgery PJI risk score to patients undergoing THA or TKA might benefit those undergoing workup for PJI.

Type
Original Article
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2012

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