Pico Question: Amongst post-op hip replacement patients, do those who have developed an infection versus those who do not form an infection have higher overall mortality and morbidity?
| Citation | Sample | Study Design | Intervention | Results | Evidence Level |
| Hessels et al. (2016) | A systematic review of 3 New York City Hospitals | Systematic review | To analyze the 2021 patients from 2006 to 2012 with an entire or fractional hip replacement or adjustment and re-surfacing process. The analysis aimed at examining the frequency and risk factors of Health Care-Associated Infections (HAI). The study specialized in the BSI, UTI, and SSI infections. | 11% of the total patients had HAI, while there was no difference in infection rates by admission year. The younger patients admitted previously in the hospital were associated with SSI infection in the hospital. The older age patients who had a bigger co-morbidity and longer pre-operative lengths of stay in the Intensive Care Unit were associated with UTI and BSI infections. | 1a |
| Moore et al. (2015) | a qualitative comparison of 19 patients with revised prosthetic joint infection (PJI) treatment from 5 National Health Services (NHS) using an interview. | Qualitative interview comparison | To compare the patients' response and experience about the impact of treatment using an antibiotic and a single revision stage or the effects of antibiotics and a 2-stage revision treatment. | The patients responded by advocating the need for all phases in the treatment of PJI. The 2-stage revision had a positive impact than the 1 –stage revision since it guaranteed the patients consistent support during rehabilitation and psychological recovery. | 5a |
| Zhu et al. (2016) | A systematic review of the accuracy of PJI re-operation data from the New Zealand Joint Registry (NZJR) and an audit of hospital records. | Systematic review | Data accuracy was compared from NZJR and audit of many hospitals to have a satisfactory recapture for PJI re-operations from 4009 cases in 3 hospitals within two years. | The NZJR data show a re-operation of PJI at a rate of 0.67% compared to 1.1% of other hospital records. The national joint registry had underestimated the rate of PJI re-operations. | 1b |
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*The study used Cincinnati Children's Hospital LEGEND system for appraisal of evidence
References
Hessels, A. J., Agarwal, M., Liu, J., & Larson, E. L. (2016). Incidence and Risk Factors for Health-Care Associated Infections after Hip Operation. Surgical infections , 17 (6), 761–765. https://doi.org/10.1089/sur.2016.062
Moore, A. J., Blom, A. W., Whitehouse, M. R., & Gooberman-Hill, R. (2015). Deep prosthetic joint infection: a qualitative study of the impact on patients and their experiences of revision surgery. BMJ Open , 5 (12). doi: 10.1136/bmjopen-2015-009495.
Zhu, M., Ravi, S., Frampton, C., Luey, C., & Young, S. (2016). New Zealand Joint Registry data underestimates the rate of prosthetic joint infection. Acta orthopaedica , 87 (4), 346–350. https://doi.org/10.3109/17453674.2016.1171639
