Safa C Fassihi1, Alex Gu1,2, Dana A Perim1, Chapman Wei1, Seth Stake1, Savyasachi Thakkar3, Anthony S Unger4, Michael P Ast5, Peter K Sculco2. 1. Department of Orthopedic Surgery, George Washington School of Medicine and Health Sciences, 2300 Eye St NW, Washington DC, 20037, USA. 2. Complex Joint Reconstruction Center, Hospital for Special Surgery, 535 E 70th St, New York City, NY, 10021, USA. 3. Department of Orthopaedic Surgery, MedStar Georgetown Orthopaedic Institute at Washington Hospital Center, 110 Irving St NW, Washington DC, 20010, USA. 4. Gildenhorn Institute of Bone and Joint Health, Sibley Memorial Hospital, 5255 Loughboro Road NW, Washington, DC, 20016, USA. 5. Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, 535 E 70th St, New York City, NY, 10021, USA.
Abstract
INTRODUCTION: The objective of this study was to determine whether chronic preoperative corticosteroid use is associated with increased infectious complications following revision total knee arthroplasty (rTKA). METHODS: A retrospective cohort analysis was conducted using patients from a large national database. Patients were divided into two cohorts based upon chronic steroid usage preoperatively. Infectious complications in the 30-day postoperative period were recorded, and univariate and multivariate analyses were performed. RESULTS: A total of 10,973 patients were included in this study. No significant difference was observed in surgical site infection rates between patients with and without preoperative steroid use. In multivariate analysis, preoperative steroid use was independently associated with an increased likelihood of septic shock (OR 6.17; p = 0.015) and prolonged length-of-stay (OR 1.57; p = 0.038). CONCLUSION: Chronic preoperative steroid is not a significant risk factor for surgical site infection following rTKA, but it is independently associated with increased risk of septic shock and prolonged hospital length of stay.
INTRODUCTION: The objective of this study was to determine whether chronic preoperative corticosteroid use is associated with increased infectious complications following revision total knee arthroplasty (rTKA). METHODS: A retrospective cohort analysis was conducted using patients from a large national database. Patients were divided into two cohorts based upon chronic steroid usage preoperatively. Infectious complications in the 30-day postoperative period were recorded, and univariate and multivariate analyses were performed. RESULTS: A total of 10,973 patients were included in this study. No significant difference was observed in surgical site infection rates between patients with and without preoperative steroid use. In multivariate analysis, preoperative steroid use was independently associated with an increased likelihood of septic shock (OR 6.17; p = 0.015) and prolonged length-of-stay (OR 1.57; p = 0.038). CONCLUSION: Chronic preoperative steroid is not a significant risk factor for surgical site infection following rTKA, but it is independently associated with increased risk of septic shock and prolonged hospital length of stay.
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