DOS 2016

DOS Kongressen 2016 ·

123

Risk of pneumonia and urinary tract infection after

total hip arthroplasty and the impact on survival

Eva Natalia Glassou, Torben Bæk Hansen, Alma Becic Pedersen

University clinic of hand, hip and knee surgery, Department of Orthopedic

Surgery, Regional Hospital West Jutland; University clinic of hand, hip and knee

surgery, Department of Orthopedic Surgery, Regional Hospital West Jutland;

Department of Clinical Epidemiology, Aarhus University Hospital

Background:

Pneumonia and urinary tract infection (UTI) are common infec-

tions causing increased morbidity and mortality. Both infections are standard

complications after total hip arthroplasty (THA).

Purpose / Aim of Study:

We examined the risk of postoperative pneumonia

and UTI after THA and the impact on survival.

Materials and Methods:

We used the Danish Hip Arthroplasty Register to

identify THAs due to OA from 2000 to 2013. From administrative databases we

collected data about comorbidity, mortality and infections in relation to the pri-

mary hospitalization and potential predictive variables. Regression models were

used to estimate associations between potential risk factors and infections and

between infections and 90-day mortality. The latter presented as relative risk

(RR) with 95% confidence intervals (CI).

Findings / Results:

In total 84,812 THAs were included. The risk of pneumonia

and UTI within 30 days of the primary procedure were 0.47 (CI 0.42 – 0.52)

and 0.56 (CI 0.51 – 0.61), respectively. Common patient related risk factors

for infections were age of 80 years or more and a comorbidity burden at time

of surgery. For pneumonia, individual risk factors were male gender, diabetes

and CPD. For UTI, female gender was an individual risk factor. For patients with

pneumonia, the RR of 90 days mortality was 13.12 (7.94 – 21.68). For pa-

tients with UTI, the RR was 1.23 (0.30 – 4.96).

Conclusions:

The risks of pneumonia and UTI within 30 days of the primary

procedure were low but when experiencing specially pneumonia the short term

risk of dying increased. Age and comorbidity were the most important risk fac-

tors for pneumonia and UTI. Individual initiatives to reduce the risk of especially

pneumonia in selected patient groups can be essential in the effort to optimize

the outcome after THA.

No conflicts of interest reported

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