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J Hosp Infect. 2019 Sep;103(1):64-68. doi: 10.1016/j.jhin.2019.04.005. Epub 2019 Apr 10.

Age alone is not a risk factor for periprosthetic joint infection.

Author information

1
Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA, USA; Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan.
2
Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA, USA; Department of Orthopaedic Surgery, General Hospital of People's Liberation Army, Beijing, China.
3
Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA, USA; Iran University of Medical Science, Tehran, Iran.
4
Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA, USA. Electronic address: javadparvizi@gmail.com.

Abstract

BACKGROUND:

It is not known whether age alone or the increased comorbidities in older patients are responsible for the higher rate of periprosthetic joint infection (PJI) in older patients.

AIM:

To test the hypothesis that age alone is not a risk factor for PJI after total joint arthroplasty.

METHODS:

This retrospective study included the review of 23,966 patients undergoing primary total hip and knee arthroplasty between January 1st, 2010 and December 31st, 2016 at a single institution. Patients who developed PJI, as defined by International Consensus Meeting criteria, were identified. All enrolled patients were divided into three groups that included patients aged <65 years (N = 12,761), 65-74 years (N = 6850) and ≥75 years (N = 4355). Using multivariate analysis and propensity score matching analysis, the possible association between age and PJI was examined.

FINDINGS:

The incidence of PJI in the entire cohort was 0.72% (171 out of 23,966). Multivariate analysis adjusting for all variables, except age, demonstrated that, compared to the patients aged <65 years, there was no statistically significant difference in the rate of PJI for patients aged 65-74 years (odds ratio: 0.89; 95% confidence interval: 0.55-1.42; P = 0.62) or for patients aged ≥75 years (0.69; 0.36-1.32; P = 0.26).

CONCLUSION:

When adjusting for confounding variables, age alone is not a risk factor for PJI. Studies evaluating the influence of age on the incidence of PJI should take into account the other confounding variables that contribute to PJI.

KEYWORDS:

Age; Periprosthetic joint infection; Risk factor; Total joint arthroplasty

PMID:
30980859
DOI:
10.1016/j.jhin.2019.04.005
[Indexed for MEDLINE]

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