MP10-15 THE IMPACT OF COMMON UROLOGIC COMPLICATIONS ON THE RISK OF A PROSTHETIC JOINT INFECTION Article Swipe

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Nahid Punjani , Brent A. Lanting , J. Andrew McClure , Jennifer Winick‐Ng , Blayne Welk ·

YOU? · · 2018 · Open Access · · DOI: https://doi.org/10.1016/j.juro.2018.02.361

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Kidney & Bladder I1 Apr 2018MP10-15 THE IMPACT OF COMMON UROLOGIC COMPLICATIONS ON THE RISK OF A PROSTHETIC JOINT INFECTION Nahid Punjani, Brent Lanting, Andrew McClure, Jennifer Winick-Ng, and Blayne Welk Nahid PunjaniNahid Punjani More articles by this author , Brent LantingBrent Lanting More articles by this author , Andrew McClureAndrew McClure More articles by this author , Jennifer Winick-NgJennifer Winick-Ng More articles by this author , and Blayne WelkBlayne Welk More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.361AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Prosthetic infections after total hip arthroplasty (THA) and total knee arthroplasty (TKA) are significant complications, and there are conflicting reports of their association with urologic complications. The purpose of this study is to determine if urinary tract infection (UTI) and acute urinary retention (AUR) are significant risk factors for joint infections after THA or TKA. METHODS This study is a population-based retrospective cohort study of all patients greater than 66 years of age undergoing a THA or TKA in Ontario, Canada between April 1, 2003 and March 31, 2013 (n = 113,061). Cases were reviewed for post-operative UTI requiring presentation to the emergency department or hospital admission within 2 years of joint replacement, as well as acute urinary retention within 30 days of THA/TKA. The primary outcome is joint infection requiring hospital admission following THA and TKA. We hypothesized that both UTI and AUR would increase the risk of subsequent joint infection after arthroplasty. RESULTS A total of 113,061 patients met inclusion criteria and had arthroplasties during the study period (44,495 with THA and 68,566 with TKA). Median age was 74 (IQR 70-79). A total of 28,256 (25.0%) had at least one UTI, and were more likely to be older, female, have previous antibiotic exposure, cystoscopy or retention, and have atrial fibrillation. A total of 2,516 (2.2%) patients had AUR within 30 days of procedure, and were more likely to be older, male, have medical comorbidities, previous transurethral procedures or cystoscopy, previous Urology visits and a general anesthetic during their procedure. A total of 1,262 (1.1%) patients had joint infection requiring hospital admission at a median of 86 days (IQR 21-377). In multivariate Cox regression analysis, UTI was associated with an increased risk of joint infection (HR 1.21, 95% CI 1.14-1.28, p<0.01). However multivariate analysis did not demonstrate an association with AUR and joint infection (HR 0.99, 95% CI 0.60-1.64, p=0.98). CONCLUSIONS UTI is associated with increased risk of peri-prosthetic joint infection of THA or TKA, whereas acute urinary retention is not a significant risk factor. Timely and appropriate treatment of symptomatic UTIs in this patient population may be important in prevention of prosthetic joint infection. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e122-e123 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Nahid Punjani More articles by this author Brent Lanting More articles by this author Andrew McClure More articles by this author Jennifer Winick-Ng More articles by this author Blayne Welk More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

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Medicine Genitourinary system Joint arthroplasty Cohort Urinary system Retrospective cohort study Arthroplasty Surgery Population Internal medicine Environmental health

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Type: article
Language: en
Landing Page: https://doi.org/10.1016/j.juro.2018.02.361
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DOI: https://doi.org/10.1016/j.juro.2018.02.361

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Title: MP10-15 THE IMPACT OF COMMON UROLOGIC COMPLICATIONS ON THE RISK OF A PROSTHETIC JOINT INFECTION

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Publication year: 2018

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Publication date: 2018-04-01

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Authors: Nahid Punjani, Brent A. Lanting, J. Andrew McClure, Jennifer Winick‐Ng, Blayne Welk

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Landing page: https://doi.org/10.1016/j.juro.2018.02.361

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Concepts: Medicine, Genitourinary system, Joint arthroplasty, Cohort, Urinary system, Retrospective cohort study, Arthroplasty, Surgery, Population, Internal medicine, Environmental health

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abstract_inverted_index.113,061	258
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abstract_inverted_index.199Issue	459
abstract_inverted_index.21-377).	370
abstract_inverted_index.Jennifer	36, 68, 490
abstract_inverted_index.Lanting,	33
abstract_inverted_index.McClure,	35
abstract_inverted_index.Ontario,	179
abstract_inverted_index.Punjani,	31
abstract_inverted_index.THA/TKA.	223
abstract_inverted_index.ToolsAdd	90
abstract_inverted_index.UROLOGIC	20
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abstract_inverted_index.articles	45, 54, 63, 72, 82, 472, 479, 486, 493, 500
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abstract_inverted_index.hospital	205, 231, 361
abstract_inverted_index.increase	245
abstract_inverted_index.p<0.01).	391
abstract_inverted_index.p=0.98).	410
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abstract_inverted_index.urologic	124
abstract_inverted_index.113,061).	191
abstract_inverted_index.2018Page:	461
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abstract_inverted_index.Winick-Ng	70, 491
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abstract_inverted_index.analysis,	375
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abstract_inverted_index.e122-e123	462
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abstract_inverted_index.exposure,	304
abstract_inverted_index.following	233
abstract_inverted_index.important	449
abstract_inverted_index.inclusion	261
abstract_inverted_index.increased	381, 416
abstract_inverted_index.infection	137, 229, 251, 359, 385, 404, 421
abstract_inverted_index.requiring	198, 230, 360
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abstract_inverted_index.treatment	439
abstract_inverted_index.0.60-1.64,	409
abstract_inverted_index.1.14-1.28,	390
abstract_inverted_index.OBJECTIVES	99
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abstract_inverted_index.Prosthetic	100
abstract_inverted_index.WelkBlayne	79
abstract_inverted_index.Winick-Ng,	37
abstract_inverted_index.anesthetic	347
abstract_inverted_index.antibiotic	303
abstract_inverted_index.associated	378, 414
abstract_inverted_index.cystoscopy	305
abstract_inverted_index.department	203
abstract_inverted_index.infection.	455
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abstract_inverted_index.population	446
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abstract_inverted_index.procedure,	324
abstract_inverted_index.procedure.	350
abstract_inverted_index.procedures	338
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abstract_inverted_index.regression	374
abstract_inverted_index.retention,	307
abstract_inverted_index.subsequent	249
abstract_inverted_index.undergoing	173
abstract_inverted_index.2018MP10-15	15
abstract_inverted_index.CONCLUSIONS	411
abstract_inverted_index.Information	468
abstract_inverted_index.appropriate	438
abstract_inverted_index.association	122, 399
abstract_inverted_index.conflicting	118
abstract_inverted_index.cystoscopy,	340
abstract_inverted_index.demonstrate	397
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abstract_inverted_index.presentation	199
abstract_inverted_index.replacement,	212
abstract_inverted_index.Advertisement	463, 506, 507
abstract_inverted_index.COMPLICATIONS	21
abstract_inverted_index.Genitourinary	8
abstract_inverted_index.McClureAndrew	60
abstract_inverted_index.Permissions©	466
abstract_inverted_index.accessJournal	2
abstract_inverted_index.arthroplasty.	253
abstract_inverted_index.fibrillation.	311
abstract_inverted_index.retrospective	161
abstract_inverted_index.transurethral	337
abstract_inverted_index.CitationsTrack	93
abstract_inverted_index.arthroplasties	265
abstract_inverted_index.comorbidities,	335
abstract_inverted_index.complications,	114
abstract_inverted_index.complications.	125
abstract_inverted_index.post-operative	196
abstract_inverted_index.downloadLoading	509
abstract_inverted_index.peri-prosthetic	419
abstract_inverted_index.population-based	160
abstract_inverted_index.2018MetricsAuthor	467
abstract_inverted_index.Winick-NgJennifer	69
abstract_inverted_index.favoritesDownload	92
abstract_inverted_index.ShareFacebookTwitterLinked	95
abstract_inverted_index.CitationsPermissionsReprints	94
abstract_inverted_index.2018FiguresReferencesRelatedDetails	457
abstract_inverted_index.UrologyInfections/Inflammation/Cystic	4
abstract_inverted_index.Informationhttps://doi.org/10.1016/j.juro.2018.02.361AboutPDF	89
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