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Correlation between Body Mass Index and Periprosthetic Joint Infection following Total Joint Arthroplasty: A protocol
Jing-Li Xu1, Zheng-Rong Liang2, Bing-Lang Xiong1
1Zhanjiang first hospital of Traditional Chinese Medicine, Zhanjiang.
Background:
Despite rapid reports on the correlation between body mass index (BMI) and periprosthetic joint infection (PJI) after total joint arthroplasty, some have conducted regression tests or meta-analyses with controversial results. In this study, we systematically meta-analyzed relevant trials and carefully evaluated the correlation for verification.
Methods:
Literature on the correlation between BMI and PJI following total joint arthroplasty was retrieved in PubMed, Embase and Cochrane Library due September 2019. Stata 13.0 software was adopted for data synthesis and analyses of publication bias and sensitivity. Random-effect models were used to summary the overall estimate of the multivariate adjusted odds ratio (OR)/hazard ratio/rate ratio with 95% confidence intervals (CIs).
Results:
A total of 29 observational studies representing 3,204,887 patients were included. The meta-analysis revealed that the risk of postoperative PJI significantly increased by 1.51 times in the obese group (OR = 1.51; 95% CI = 1.30-1.74 for the obese group vs. the non-obese group), and by 3.27 times in the morbid obese group (OR = 3.27; 95% CI = 2.46-4.34 for the morbid obese group vs the non-morbid obese group). A significant association remained consistent, as indicated by subgroup analyses and sensitivity analyses.
Conclusion:
Our findings demonstrate that postoperative PJI is positively correlated with BMI, with obese patients showing a greater risk of developing PJI than non-obese patients. Similarly, morbid obese patients present a higher risk of PJI than non-morbid obese patients. However, this conclusion needs to be corroborated by more prospective studies.
Insights
Higher body mass index (BMI) significantly increases the risk of periprosthetic joint infection (PJI) after total joint arthroplasty. Obese and morbidly obese patients face substantially greater PJI risks compared to non-obese individuals.
Area of Science:
- Orthopedic Surgery
- Infectious Diseases
- Public Health
Background:
- Controversy exists regarding the correlation between body mass index (BMI) and periprosthetic joint infection (PJI) post-total joint arthroplasty.
- Previous regression tests and meta-analyses yielded conflicting results.
Purpose of the Study:
- To systematically meta-analyze existing trials evaluating the correlation between BMI and PJI.
- To verify the association between elevated BMI and increased PJI risk.
Main Methods:
- Comprehensive literature search of PubMed, Embase, and Cochrane Library up to September 2019.
- Meta-analysis of 29 observational studies involving 3,204,887 patients using random-effect models.
- Statistical analysis including publication bias and sensitivity analyses with Stata 13.0 software.
Main Results:
- Obesity was associated with a 1.51-fold increased risk of PJI (OR=1.51; 95% CI=1.30-1.74).
- Morbid obesity demonstrated a 3.27-fold increased risk of PJI (OR=3.27; 95% CI=2.46-4.34).
- Subgroup and sensitivity analyses confirmed a consistent significant association.
Conclusions:
- Postoperative PJI risk is positively correlated with BMI.
- Obese and morbidly obese patients have a significantly higher risk of developing PJI.
- Further prospective studies are recommended to corroborate these findings.
