Evidence map›Paper›PMID 40241859›Full record

ArticleJournal of orthopaedics2025

Risk factors for readmission and mortality after irrigation & debridement for septic arthritis in persons who inject drugs.

Gabriel S Linden, Laura M Krivicich, Richard N Puzzitiello, Sophie E Lipson, Vineet Desai, Jared M Alswang, Daniel Gabriel, Alysse G Wurcel, Scott P Ryan, Antonia F Chen and 1 more

Abstract read
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In one paragraph

Article in Journal of orthopaedics, 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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0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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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

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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

1 citing paper in PubMed.

  1. Article
4 · The record

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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

11 authors.

Gabriel S LindenTufts University School of Medicine, 145 Harrison Ave, Boston, MA, USA.
Laura M KrivicichTufts Medical Center, Department of Orthopedics, 800 Washington St, Boston, MA, USA.
Richard N PuzzitielloTufts Medical Center, Department of Orthopedics, 800 Washington St, Boston, MA, USA.
Sophie E LipsonTufts University School of Medicine, 145 Harrison Ave, Boston, MA, USA.
Vineet DesaiHarvard Medical School, 25 Shattuck St, Boston, MA, USA.
Jared M AlswangHarvard Medical School, 25 Shattuck St, Boston, MA, USA.
Daniel GabrielHarvard Medical School, 25 Shattuck St, Boston, MA, USA.
Alysse G WurcelBoston Medical Center, Department of Medicine Division of General Internal Medicine, One Boston Medical Center Pl, Boston, MA, USA.
Scott P RyanTufts University School of Medicine, 145 Harrison Ave, Boston, MA, USA.
Antonia F ChenUT Southwestern Medical Center, Department of Orthopaedic Surgery, 5325 Harry Hines Blvd, Dallas, Tx, USA.
Matthew J SalzlerTufts University School of Medicine, 145 Harrison Ave, Boston, MA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background and objective: Persons who inject drugs (PWID) are associated with increased risk of repeat irrigation & debridement (I&D) in the setting of native joint septic arthritis. Despite these associations, there is a lack of data regarding postoperative outcomes for PWID with septic arthritis. The primary aim of this study was to determine if PWID were associated with increased rates of readmission and mortality after I&D for septic arthritis. Materials and methods: Patients from two level one trauma centers with native joint septic arthritis from 2015 to 2019 were retrospectively identified. Patients were included if they had a clinical presentation consistent with septic arthritis. Independent sample T-tests and Fisher's Exact testing were used to compare outcomes by PWID and repeat I&D status. Primary outcomes included 30 and 90-day readmission, 30 and 90-day readmission related to septic arthritis, and 30 and 90-day mortality. Binary logistic regression testing was used to control for confounders such as human immunodeficiency virus (HIV), tobacco use disorder, diabetes, and immunocompromised status. Results: 192 patients with septic arthritis were identified (female, n = 70; male, n = 122). 231 joints were included in the analysis. There were 67 cases associated with PWID (29 %). Notably, PWID were associated with increased rates of tobacco use disorder (92 % vs. 24 %, p < 0.001) and increased immunocompromised status (81 % vs. 24 %, p < 0.001). PWID were associated with increased rates of 30-day and 90-day readmission (35 % vs. 12 %, p = 0.008; 61 % vs. 21 %, p = 0.002), and increased 30-day and 90-day mortality rate (22 % vs. 0.03 %, p < 0.001; 35 % vs 0.09 %, p = 0.001). However, these associations did not remain significant after controlling for confounders. Repeat I&D was significantly associated with increased 90-day readmission rates (OR 6.32, p < 0.001), which remained significant when controlling for confounders. Conclusions: This multicenter study demonstrated a strong association between repeat I&D and 90-day readmission rate in the setting of native joint septic arthritis. Reassuringly, repeat I&D was not associated with increased rates of postoperative mortality. PWID were associated with increased 30 and 90-day readmission and mortality rates, but these were no longer significant after controlling for confounders.

Indexed as

DebridementIrrigationMortalityPWIDReadmissionSeptic

Identifiers

PMID40241859
PMCPMC11997257

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