Prediction of Early Periprosthetic Joint Infection After Total Hip Arthroplasty.

To develop a parsimonious risk prediction model for periprosthetic joint infection (PJI) within 90 days after total hip arthroplasty (THA). We used logistic LASSO regression with bootstrap ranking to develop a risk prediction model for PJI within 90 days based on a Swedish cohort of 88,830 patients with elective THA 2008-2015. The model was externally validated on a Danish cohort with 18,854 patients. Incidence of PJI was 2.45% in Sweden and 2.17% in Denmark. A model with the underlying diagnosis for THA, body mass index (BMI), American Society for Anesthesiologists (ASA) class, sex, age, and the presence of five defined comorbidities had an area under the curve (AUC) of 0.68 (95% CI: 0.66 to 0.69) in Sweden and 0.66 (95% CI: 0.64 to 0.69) in Denmark. This was superior to traditional models based on ASA class, Charlson, Elixhauser, or the Rx Risk V comorbidity indices. Internal calibration was good for predicted probabilities up to 10%. A new PJI prediction model based on easily accessible data available before THA was developed and externally validated. The model had superior discriminatory ability compared to ASA class alone or more complex comorbidity indices and had good calibration. We provide a web-based calculator (https://erikbulow.shinyapps.io/thamortpred/) to facilitate shared decision making by patients and surgeons.

Informations de copyright

© 2022 Bülow et al.

Déclaration de conflit d'intérêts

OR is a principal investigator for research partly founded by Pfizer; OR is a register director of the Swedish Arthroplasty Register (SAR) and board member of the International Society of Arthroplasty Registries. NPH has received institutional support from Waldemar Link GmbH, and Zimmer Biomet; also reports personal fees from Heraeus Medical, Germany. NPH is president of the Nordic Arthroplasty Register Association, member of the steering committee of SAR, and Co-Editor of Acta Orthopaedica; no other relationships or activities that could appear to have influenced the submitted work. The authors report no other conflicts of interest in this work.