Observational studyArchives of orthopaedic and trauma surgery2025
Incidence, predictors, and outcomes of sepsis in revision total hip arthroplasty (rTHA).
Observational study in Archives of orthopaedic and trauma surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- 30-day Mortality Following Revision of Hip Arthroplasty, A Cohort Study Based on the Swedish Perioperative Registry 2017-2022.Geriatric orthopaedic surgery & rehabilitation · 2025Article
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Abstract
introductionRevision total hip arthroplasty (rTHA) is increasingly common, with sepsis being a serious but rare complication. Sepsis rates in rTHA vary widely, and understanding risk factors is crucial for improving outcomes. This study aims to evaluate the incidence of sepsis following rTHA and identify preoperative and intraoperative predictors.
methodsA retrospective observational study using the ACS NSQIP (American College of Surgeons National Surgical Quality Improvement Program) database analyzed 12,966 rTHA patients (2016-2021). Predictors of sepsis were identified through univariate and multivariate analysis, including demographic, comorbid, and surgical factors. The primary endpoint was identifying sepsis predictors; secondary endpoints included sepsis incidence across patient groups.
resultsIn a cohort of 12,966 patients undergoing revision total hip arthroplasty, the incidence of sepsis was 1.9% (251 patients). Preoperative factors associated with increased sepsis incidence included diabetes (2.6%), smoking (2.9%), dyspnea (3.7%), severe chronic obstructive pulmonary disease (COPD) (3.5%), dialysis (5.3%), open wounds (9.5%), steroid use (3.1%), partial/total dependence (3.5%), and American society of anesthesiologists (ASA) III-IV status (2.7%). Multivariate analysis identified several predictors of sepsis, including age (OR + 0.02 per year), total operation time (OR -0.004 per minute), open wounds (OR 3.6), severe COPD (OR 1.9), transfusion within 72 h (OR 3.3), dyspnea (OR 8.1), and emergent cases (OR 3.4). The sepsis group had higher adverse outcomes, including a 30-day mortality rate of 0.8% (vs. 0.22% in non-septic patients), higher rates of deep vein thrombosis (2.8% vs. 0.7%), pulmonary embolism (1.6% vs. 0.5%), stroke (0.8% vs. 0.2%), and acute renal failure (1.2% vs. 0.1%), all with significant p-values and higher odds ratios.
conclusionSepsis after rTHA is a significant complication. Predictors include age, open wounds, COPD, dyspnea, and transfusions. Identifying at-risk patients can improve prevention and management strategies to enhance patient outcomes.
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