Evidence map›Paper›PMID 32787972›Full record

Observational studyJournal of orthopaedic surgery and research2020

Metabolic factors and post-traumatic arthritis may influence the increased rate of surgical site infection in patients with human immunodeficiency virus following total hip arthroplasty.

Carol A Lin, Phillip H Behrens, Guy Paiement, W David Hardy, James Mirocha, Robert L Rettig, Heidi L Kiziah, Andrew G Rudikoff, Antonio Hernandez Conte

Open access · goldAbstract readObservational Study
In one paragraph

Observational study in Journal of orthopaedic surgery and research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.4field-weighted citation impact, top 43% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 2 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Carol A LinDepartment of Orthopedic Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Phillip H BehrensDepartment of Orthopedic Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Guy PaiementDepartment of Orthopedic Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
W David HardyDivision of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
James MirochaDivision of Biostatistics & Bioinformatics, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Robert L RettigDepartment of Surgery, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA.
Heidi L KiziahDepartment of Anesthesiology, Kaiser Permanente Los Angeles Medical Center, 4867 Sunset Blvd, 3rd Floor, Suite 3017, Los Angeles, CA, 90027, USA.
Andrew G RudikoffDepartment of Anesthesiology, Kaiser Permanente Los Angeles Medical Center, 4867 Sunset Blvd, 3rd Floor, Suite 3017, Los Angeles, CA, 90027, USA.
Antonio Hernandez ConteDepartment of Anesthesiology, Kaiser Permanente Los Angeles Medical Center, 4867 Sunset Blvd, 3rd Floor, Suite 3017, Los Angeles, CA, 90027, USA. Antonio.Conte@kp.org.ORCID http://orcid.org/0000-0002-9335-462X
Cedars-Sinai Medical Center · USKaiser Permanente · USJohns Hopkins University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe impact of CD4+ T-cell count and highly active antiretroviral therapy (HAART) on the rate of surgical site infection (SSI) in patients with human immunodeficiency virus (HIV) undergoing total hip arthroplasty is still unclear. The goals of this study were to assess the rate of perioperative infection at a large tertiary care referral center and to identify risk factors in HIV+ patients undergoing total hip arthroplasty (THA).

methodsThis study was a prospective, observational study at a single medical center from 2000-2017. Patients who were HIV+ and underwent THA were followed from the preoperative assessment period, through surgery and for a 2-year follow-up period.

resultsSixteen of 144 HIV+ patients (11%) undergoing THA developed perioperative surgical site infections. Fourteen patients (10%) required revision THA within a range of 12 to 97 days after the initial surgery. The patients' mean age was 49.6 ± 4.5 years, and the most common diagnosis prompting THA was osteonecrosis (96%). Patients who developed SSI had a lower waist-hip ratio (0.86 vs. 0.93, p = 0.047), lower high density lipoprotein cholesterol (45.8 vs. 52.5, p = 0.015) and were more likely to have post-traumatic arthritis (12.5% vs. 0%, p = 0.008). Logistic regression analysis demonstrated that current alcohol use and higher waist-hip ratio were significant protectors against infection (p < 0.05). No other demographic, medical, immunologic parameters, or specific HAART regimens were associated with perioperative infection.

conclusionsImmunologic status as measured by CD4+ cell count, HIV viral load, and medical therapy do not appear to influence the development of SSI in HIV+ patients undergoing THA. Metabolic factors and post-traumatic arthritis may influence the increased rate of infection in HIV+ patients following THA.

Indexed as

Antiretroviral Therapy, Highly ActiveArthroplasty, Replacement, HipAdultCD4-Positive T-LymphocytesHIV InfectionsHumansImmunocompromised HostMiddle AgedProspective StudiesSurgical Wound InfectionViral LoadHighly active antiretroviral therapy (HAART)Human immunodeficiency virus (HIV)Surgical site infection (SSI)Total hip arthroplasty

Identifiers

PMID32787972
PMCPMC7425402
OpenAlexW3048831285

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.