E Laurent1, G Gras2, J Druon3, P Rosset4, S Baron5, A Le-Louarn6, E Rusch5, L Bernard7, L Grammatico-Guillon8. 1. Unité régionale d'épidémiologie hospitalière (UREH), Centre-Val de Loire, Centre Hospitalier régional universitaire (CHRU) de Tours, 37000 Tours, France; Équipe de Recherche EE1 EES, université de Tours, 37000 Tours, France. Electronic address: e.laurent@chu-tours.fr. 2. Service de maladies infectieuses, CHRU de Tours, 37000 Tours, France. 3. Service de chirurgie orthopédique, CHRU de Tours, 37000 Tours, France. 4. Service de chirurgie orthopédique, CHRU de Tours, 37000 Tours, France; Faculté de médecine, université de Tours, 37000 Tours, France. 5. Unité régionale d'épidémiologie hospitalière (UREH), Centre-Val de Loire, Centre Hospitalier régional universitaire (CHRU) de Tours, 37000 Tours, France; Équipe de Recherche EE1 EES, université de Tours, 37000 Tours, France. 6. Unité régionale d'épidémiologie hospitalière (UREH), Centre-Val de Loire, Centre Hospitalier régional universitaire (CHRU) de Tours, 37000 Tours, France. 7. Service de maladies infectieuses, CHRU de Tours, 37000 Tours, France; Faculté de médecine, université de Tours, 37000 Tours, France. 8. Unité régionale d'épidémiologie hospitalière (UREH), Centre-Val de Loire, Centre Hospitalier régional universitaire (CHRU) de Tours, 37000 Tours, France; Faculté de médecine, université de Tours, 37000 Tours, France.
Abstract
OBJECTIVES: French reference centers for bone and joint infections (BJI) were implemented from 2009 onwards to improve the management of complex BJIs. This study compared BJI burden before and after the implementation of these reference centers. PATIENTS AND METHODS: BJI hospital stays were selected from the 2008 and 2013 national hospital discharge database using a validated algorithm, adding the new complex BJI code created in 2011. Epidemiology and economic burden were assessed. RESULTS: BJI prevalence increased in 2013 (70 vs. 54/100,000 in 2008). Characteristics of BJI remained similar between 2008 and 2013: septic arthritis (50%), increasing prevalence with age and sex, case fatality 5%, mean length of stay 17.5 days, rehospitalization 20%. However, device-associated BJIs increased (34 vs. 26%) as well as costs (€421 million vs. €259 in 2008). Similar device-associated BJI characteristics between 2008 and 2013 were: septic arthritis (70%), case fatality (3%), but with more hospitalizations in reference centers (34 vs. 30%) and a higher cost per stay. Among the 7% of coded complex BJIs, the mean length of stay was 22.2 days and mean cost was €11,960. CONCLUSIONS: BJI prevalence highly increased in France. Complex BJI prevalence assessment is complicated by the absence of clinical consensus and probable undercoding. A validation of clinical case definition of complex BJI is required.
OBJECTIVES: French reference centers for bone and joint infections (BJI) were implemented from 2009 onwards to improve the management of complex BJIs. This study compared BJI burden before and after the implementation of these reference centers. PATIENTS AND METHODS: BJI hospital stays were selected from the 2008 and 2013 national hospital discharge database using a validated algorithm, adding the new complex BJI code created in 2011. Epidemiology and economic burden were assessed. RESULTS: BJI prevalence increased in 2013 (70 vs. 54/100,000 in 2008). Characteristics of BJI remained similar between 2008 and 2013: septic arthritis (50%), increasing prevalence with age and sex, case fatality 5%, mean length of stay 17.5 days, rehospitalization 20%. However, device-associated BJIs increased (34 vs. 26%) as well as costs (€421 million vs. €259 in 2008). Similar device-associated BJI characteristics between 2008 and 2013 were: septic arthritis (70%), case fatality (3%), but with more hospitalizations in reference centers (34 vs. 30%) and a higher cost per stay. Among the 7% of coded complex BJIs, the mean length of stay was 22.2 days and mean cost was €11,960. CONCLUSIONS: BJI prevalence highly increased in France. Complex BJI prevalence assessment is complicated by the absence of clinical consensus and probable undercoding. A validation of clinical case definition of complex BJI is required.
Authors: Adrien Lemaignen; Leslie Grammatico-Guillon; Pascal Astagneau; Simon Marmor; Tristan Ferry; Anne Jolivet-Gougeon; Eric Senneville; Louis Bernard Journal: Bone Joint Res Date: 2020-10-10 Impact factor: 5.853
Authors: Carlo L Romanò; Andreas G Tsantes; Dimitrios V Papadopoulos; Hiroyuki Tsuchiya; Thami Benzakour; Joseph Benevenia; Hernán Del Sel; Lorenzo Drago; Andreas F Mavrogenis Journal: SICOT J Date: 2022-08-15