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Age Alone is Not a Risk Factor for Periprosthetic Joint Infection

Daisuke Inoue, Chi Xu, Hamidreza Yazdi, Javad Parvizi
Journal of Hospital Infection 2019 April 10

BACKGROUND: It is not known whether age alone or the increased comorbidities in the older patients are responsible for the higher rate of periprosthetic joint infection (PJI) in the older patients. The hypothesis of this study was that age alone is not a risk factor for PJI after total joint arthroplasty.

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

RESULTS: The incidence of PJI in the entire cohort was 0.72% (171/23,966). Multivariate analysis adjusting for all variables, except age, demonstrated that, compared to the patients younger than 65, there was no statistically significant difference in the rate of PJI for patients in the 65 to 74 year group (OR 0.89; 95% CI, 0.55-1.42; P =0.62) or patients 75 years and older group (OR 0.69; 95% CI, 0.36-1.32; P =0.26).

CONCLUSIONS: When adjusting for confounding variables, we found that 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.


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