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Comparative Study
. 2011 Dec;82(6):646-54.
doi: 10.3109/17453674.2011.636671. Epub 2011 Nov 9.

Infection after primary hip arthroplasty: a comparison of 3 Norwegian health registers

Håvard Dale  1 , Inge Skråmm, Hege L Løwer, Hanne M Eriksen, Birgitte Espehaug, Ove Furnes, Finn Egil Skjeldestad, Leif I Havelin, Lars B Engesaeter
Affiliations
Comparative Study

Infection after primary hip arthroplasty: a comparison of 3 Norwegian health registers

Håvard Dale et al. Acta Orthop. 2011 Dec.

Abstract

Background and purpose: The aim of the present study was to assess incidence of and risk factors for infection after hip arthroplasty in data from 3 national health registries. We investigated differences in risk patterns between surgical site infection (SSI) and revision due to infection after primary total hip arthroplasty (THA) and hemiarthroplasty (HA).

Materials and methods: This observational study was based on prospective data from 2005-2009 on primary THAs and HAs from the Norwegian Arthroplasty Register (NAR), the Norwegian Hip Fracture Register (NHFR), and the Norwegian Surveillance System for Healthcare-Associated Infections (NOIS). The Norwegian Patient Register (NPR) was used for evaluation of case reporting. Cox regression analyses were performed with revision due to infection as endpoint for data from the NAR and the NHFR, and with SSI as the endpoint for data from the NOIS.

Results: The 1-year incidence of SSI in the NOIS was 3.0% after THA (167/5,540) and 7.3% after HA (103/1,416). The 1-year incidence of revision due to infection was 0.7% for THAs in the NAR (182/24,512) and 1.5% for HAs in the NHFR (128/8,262). Risk factors for SSI after THA were advanced age, ASA class higher than 2, and short duration of surgery. For THA, the risk factors for revision due to infection were male sex, advanced age, ASA class higher than 1, emergency surgery, uncemented fixation, and a National Nosocomial Infection Surveillance (NNIS) risk index of 2 or more. For HAs inserted after fracture, age less than 60 and short duration of surgery were risk factors of revision due to infection.

Interpretation: The incidences of SSI and revision due to infection after primary hip replacements in Norway are similar to those in other countries. There may be differences in risk pattern between SSI and revision due to infection after arthroplasty. The risk patterns for revision due to infection appear to be different for HA and THA.

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Figures

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Number of primary THAs and HAs (red squares) included in the NOIS, the NAR, and the NHFR, including number of arthroplasties with missing data on the confounders and incomplete 30–day and 1–year follow–up. a The NOIS registers arthroplasties 3 months every year. Not all hospitals that reported to the NAR and the NHFR reported to the NOIS. (NOIS is a Norwegian acronym).
See this image and copyright information in PMC

References

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