Hypoalbuminemia Increases Mortality after Two-Stage Revision Total Joint Arthroplasty
Publish place: The Archives of Bone and Joint Surgery، Vol: 11، Issue: 3
Publish Year: 1402
نوع سند: مقاله ژورنالی
زبان: English
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شناسه ملی سند علمی:
JR_TABO-11-3_005
تاریخ نمایه سازی: 20 اسفند 1401
Abstract:
Objectives: This study aimed to evaluate the effect of hypoalbuminemia on failure rates and mortality after a two-stage revision for PJI.Methods: ۱۹۹ Patients (۱۳۰ knees and ۶۹ hips) with a mean age of ۶۴.۷ ± ۱۰.۷ years who underwent a two-stage exchange were retrospectively reviewed at a mean of ۵۱.۲ ± ۳۹.۷ months. Failure of treatment was defined as any revision within the follow-up period, failure to undergo reimplantation, or death within one year of initiating treatment.Results: There were ۷۱ failures (۳۵.۷%), including ۳۸ septic failures (۱۹.۱%). We found no differences between successful revisions and failures regarding hypoalbuminemia (۴۳% vs. ۴۲% prior to stage ۱, P=۱ and ۳۲% vs. ۲۹% prior to stage ۲, P=۰.۸۵۶). There were also no differences in hypoalbuminemia rates between septic failures and the rest of the cohort (۴۲% vs. ۴۳% prior to stage ۱, P=۱.۰ and ۳۴% vs. ۳۰% prior to stage ۲, P=۰.۶۷۴). Hypoalbuminemia prior to stage ۲ was a significant predictor of mortality based on multivariate analysis (odds ratio ۵.۴۰, CI ۱.۱۹-۲۴.۵۴, P=۰.۰۲۹). Hypoalbuminemia was independently associated with a greater length of stay by ۲.۲ days after stage ۱ (P=۰.۰۰۲) and by ۱.۰ days after the second stage reimplantation (P=۰.۰۰۴).Conclusion: Preoperative hypoalbuminemia is a significant predictor of mortality and increased length of stay following two-stage revision but is not a predictor of failure of PJI treatment. Further study is required to understand if hypoalbuminemia is a modifiable risk factor or a marker for poor outcomes.Level of evidence: III
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Authors
Jonathan Guntin
Rush University Medical Center Department of Orthopedic Surgery, Chicago, IL, USA
Joseph Serino
Rush University Medical Center Department of Orthopedic Surgery, Chicago, IL, USA
David Rossi
Rush University Medical Center Department of Orthopedic Surgery, Chicago, IL, USA
Anthony Boniello
Rush University Medical Center Department of Orthopedic Surgery, Chicago, IL, USA
Charles Gusho
Rush University Medical Center Department of Orthopedic Surgery, Chicago, IL, USA
Craig Della Valle
Rush University Medical Center Department of Orthopedic Surgery, Chicago, IL, USA