Social Determinants of Health Are Associated With Increased Risk of Preoperative Methicillin-Resistant

Background: Social determinants of health (SDOH) are associated with disparities in health outcomes and increased vulnerability to infectious diseases. This study evaluated the association between SDOH and methicillin-resistant Methods: A retrospective cohort study was conducted using the United States TriNetX Research Network. Adults aged 18 years or older who underwent primary THA, TKA, or TSA were identified. Propensity score matching was performed using demographic variables and comorbidities. MRSA colonization rates were compared using risk ratios (RRs) with 95% confidence intervals (CIs), and subanalyses were conducted by joint type and age group. Cox regression evaluated independent risk predictors. Results: SDOH were associated with a significantly higher risk of preoperative MRSA colonization across all joint types, including THA (2.2% vs 0.8%; RR, 2.74; 95% CI, 1.85-4.04), TKA (2.4% vs 1.1%; RR, 2.16; 95% CI, 1.60-2.92), and TSA (3.0% vs 1.6%; RR, 1.95; 95% CI, 1.16-3.29) (all Conclusions: Social disadvantage was associated with an increased risk of MRSA colonization among patients undergoing primary total joint arthroplasties. These findings highlight the need for increased SDOH documentation and incorporation into preoperative risk stratification and infection prevention strategies. Level of Evidence: III.