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与非血源性近假肢关节感染相比,血源性近假肢关节感染的治疗失败率很高

Leonard Knoll¹, Simon D Steppacher², Hansjakob Furrer¹

¹Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland.

The bone & joint journal

|November 30, 2023

概括

血源性周围假肢关节感染 (PJI) 的失败率高于非血源性PJI. 假肢保留是两种类型的PJI失败的主要风险因素.

科学领域:

整形外科手术整形外科手术
传染性疾病传染性疾病
生物医学工程生物医学工程

背景情况:

周围假肢关节感染 (PJI) 在骨科手术中构成了重大挑战.
血源性PJI,源于远处的感染源,与非血源性PJI相比,与更高的失败率有关.
导致这种差异的根本原因和特定风险因素仍然不完全理解.

研究的目的:

调查和比较血液和非血液PJI的结果.
识别和分析与两组PJI治疗失败相关的风险因素.
为了阐明这两种PJI病因之间的失败率的差异.

主要方法:

膝盖或部PJI发作的回顾性队列研究 (2015年1月 - 2020年10月).
根据感染路径,PJI病例的分层分为血源性和非血源性组.
卡普兰-梅尔生存分析用于无故障生存和日志等级测试用于组比较;单变量和多变量分析用于风险因素识别.

主要成果:

总共分析了305个PJI发作 (146个是血源性,159个是非血源性).
在血源性PJI (55%) 与非血源性PJI (74%) (p=0.021) 中,六年无故障存活率显著较低.
假肢保留成为两组多变量分析失败的唯一独立风险因素.

结论:

血源性PJI显示与非血源性PJI相比,治疗失败率显著更高.
假肢保留的手术策略被确定为PJI失败的关键独立风险因素,无论感染的来源如何.
进一步研究优化血源性PJI的管理策略是有必要的.

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