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Volume 18
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Article

Incidence and Risk Factors of 30-Day Surgical Site Infection after Primary Total Joint Arthroplasty in a Middle-Income Country: A Single-Center Experience

by
Vuk Marusic
1,*,
Ljiljana Markovic-Denic
1,
Olivera Djuric
2,3,
Andja Cirkovic
4,
Vladimir Nikolic
1,
Emilija Dubljanin-Raspopovic
5,6 and
Marko Kadija
5,7
1
Institute of Epidemiology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
2
Section of Public Health, Center for Environmental, Department of Biomedical, Metabolic and Neural Sciences, Nutritional and Genetic Epidemiology (CREAGEN), University of Modena and Reggio Emilia, 41121 Modena, Italy
3
Epidemiology Unit, Azienda Unità Sanitaria Locale—IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy
4
Institute of Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
5
Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
6
Clinic for Physical Medicine and Rehabilitation, Clinical Center Serbia, 11000 Belgrade, Serbia
7
Institute for Orthopedic Surgery and Traumatology, Clinical Centre of Serbia, 11000 Belgrade, Serbia
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2021, 18(3), 863; https://doi.org/10.3390/ijerph18030863
Submission received: 10 December 2020 / Revised: 9 January 2021 / Accepted: 13 January 2021 / Published: 20 January 2021
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Abstract

The data about the incidence and risk factors for surgical site infections (SSIs) following total joint arthroplasty (TJA) in middle-income countries are still scant. The aim of this study was to assess the incidence and risk factors associated with 30-day SSIs following total hip arthroplasty (THA) and total knee arthroplasty (TKA). The study was conducted at the Clinic for Orthopedic Surgery and Traumatology, Clinical Center of Serbia (CCS) in Belgrade, from May 2016 to April 2018. All patients undergoing THA or TKA were followed throughout hospitalization until day 30 after discharge. Of the 1073 admitted patients, 459 had THA and 230 had TKA. The incidence rate of surgical site infections (SSIs) among the patients who underwent THA was 5.4%, which is 3.8 per 1000 postoperative patient-days, while the rate among those who had TKA was 4.8%, i.e., 3.4 per 1000 postoperative patient-days. Out of the 36 SSIs, 15 were deep and 21 were superficial incisional ones. Among the variables examined, the independent risk factors for SSIs after THA were the American Society of Anesthesiologists (ASA) score > 2 (RR = 3.17; 95% CI—1.26–8.02), smoking (RR = 3.14; 95% CI—1.26–7.82) and peripheral vascular disease (PVD) (RR = 6.09; 95% CI—2.35–15.77), and after TKA, only PVD (RR = 3.87; 95% CI—1.09–13.76) was the risk factor. Incidence rates of SSIs after arthroplasty are higher compared to reports from developed countries. Therefore, it is necessary to enhance infection prevention and control measures with strict control of modifiable risk factors.
Keywords: surgical site infection; total hip arthroplasty; total knee arthroplasty; prospective cohort study; risk factors surgical site infection; total hip arthroplasty; total knee arthroplasty; prospective cohort study; risk factors

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MDPI and ACS Style

Marusic, V.; Markovic-Denic, L.; Djuric, O.; Cirkovic, A.; Nikolic, V.; Dubljanin-Raspopovic, E.; Kadija, M. Incidence and Risk Factors of 30-Day Surgical Site Infection after Primary Total Joint Arthroplasty in a Middle-Income Country: A Single-Center Experience. Int. J. Environ. Res. Public Health 2021, 18, 863. https://doi.org/10.3390/ijerph18030863

AMA Style

Marusic V, Markovic-Denic L, Djuric O, Cirkovic A, Nikolic V, Dubljanin-Raspopovic E, Kadija M. Incidence and Risk Factors of 30-Day Surgical Site Infection after Primary Total Joint Arthroplasty in a Middle-Income Country: A Single-Center Experience. International Journal of Environmental Research and Public Health. 2021; 18(3):863. https://doi.org/10.3390/ijerph18030863

Chicago/Turabian Style

Marusic, Vuk, Ljiljana Markovic-Denic, Olivera Djuric, Andja Cirkovic, Vladimir Nikolic, Emilija Dubljanin-Raspopovic, and Marko Kadija. 2021. "Incidence and Risk Factors of 30-Day Surgical Site Infection after Primary Total Joint Arthroplasty in a Middle-Income Country: A Single-Center Experience" International Journal of Environmental Research and Public Health 18, no. 3: 863. https://doi.org/10.3390/ijerph18030863

APA Style

Marusic, V., Markovic-Denic, L., Djuric, O., Cirkovic, A., Nikolic, V., Dubljanin-Raspopovic, E., & Kadija, M. (2021). Incidence and Risk Factors of 30-Day Surgical Site Infection after Primary Total Joint Arthroplasty in a Middle-Income Country: A Single-Center Experience. International Journal of Environmental Research and Public Health, 18(3), 863. https://doi.org/10.3390/ijerph18030863

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