Prediction of Early Periprosthetic Joint Infection After Total Hip Arthroplasty

Erik Bülow*, Ute Hahn, Ina Trolle Andersen, Ola Rolfson, Alma Becic Pedersen, Nils P Hailer

*Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

Abstract

Purpose: To develop a parsimonious risk prediction model for periprosthetic joint infection (PJI) within 90 days after total hip arthroplasty (THA).
Patients and Methods: 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.
Results: 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%.
Conclusion: 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.
Original languageEnglish
JournalClinical Epidemiology
Volume14
Pages (from-to)239-253
Number of pages15
ISSN1179-1349
DOIs
Publication statusPublished - 2022

Keywords

  • prediction model
  • total hip arthroplasty
  • orthopaedics
  • clinical decision-making tool
  • web calculator
  • external validation
  • Clinical decision-making tool
  • Web calculator
  • External validation
  • Prediction model
  • Total hip arthroplasty
  • Orthopaedics
  • KNEE
  • MORTALITY
  • REVISION
  • RISK-FACTORS
  • CALCULATOR
  • DIABETES-MELLITUS
  • REPLACEMENT
  • SURGICAL SITE INFECTION
  • MEDICAL COMORBIDITIES
  • COMPLICATIONS

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