Season of the year influences infection rates following total hip arthroplasty

doi:10.5312/wjo.v8.i12.895

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World Journal of Orthopedics

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Orthop. Dec 18, 2017; 8(12): 895-901
Published online Dec 18, 2017. doi: 10.5312/wjo.v8.i12.895

Season of the year influences infection rates following total hip arthroplasty

Samuel Rosas, Alvin C Ong, Leonard T Buller, Karim G Sabeh, Tsun yee Law, Martin W Roche, Victor H Hernandez

Samuel Rosas, Department of Orthopedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27101, United States

Samuel Rosas, Tsun yee Law, Holy Cross Orthopedic Institute, Fort Lauderdale, FL 33334, United States

Alvin C Ong, Orthopedic Surgery, Thomas Jefferson University Hospital, Egg Harbor Town, NJ 08234, United States

Leonard T Buller, Karim G Sabeh, Tsun yee Law, Victor H Hernandez, Department of Orthopedics Surgery, University of Miami, Miami, FL 33136, United States

Martin W Roche, Department of Orthopaedic Surgery, Holy Cross Hospital, Fort Lauderdale, FL 33316, United States

Author contributions: All of the authors contributed significantly to the data analysis and writing of this article.

Institutional review board statement: No IRB approval was required as this project utilized no patient identifying data as the data are extracted from a HIPAA compliant database.

Informed consent statement: This study was conducted by utilizing the PearlDiver Supercomputer. This allows the researchers to conduct research without requiring patient specific information and thus no informed consent was required.

Conflict-of-interest statement: None of the authors report any conflict of interest with this article.

Correspondence to: Samuel Rosas, MD, Postdoctoral Fellow, Department of Orthopedic Surgery, Wake Forest School of Medicine, 1 Medical Center Boulevard, Winston-Salem, NC 27101, United States. srosas@wakehealth.edu

Telephone: +1-336-7163950 Fax: +1-336-7167310

Received: August 17, 2017
Peer-review started: August 16, 2017
First decision: October 9, 2017
Revised: October 11, 2017
Accepted: November 22, 2017
Article in press: November 22, 2017
Published online: December 18, 2017
Processing time: 124 Days and 15 Hours

Abstract

AIM

To research the influence of season of the year on periprosthetic joint infections.

METHODS

We conducted a retrospective review of the entire Medicare files from 2005 to 2014. Seasons were classified as spring, summer, fall or winter. Regional variations were accounted for by dividing patients into four geographic regions as per the United States Census Bureau (Northeast, Midwest, West and South). Acute postoperative infection and deep periprosthetic infections within 90 d after surgery were tracked.

RESULTS

In all regions, winter had the highest incidence of periprosthetic infections (mean 0.98%, SD 0.1%) and was significantly higher than other seasons in the Midwest, South and West (P < 0.05 for all) but not the Northeast (P = 0.358). Acute postoperative infection rates were more frequent in the summer and were significantly affected by season of the year in the West.

CONCLUSION

Season of the year is a risk factor for periprosthetic joint infection following total hip arthroplasty (THA). Understanding the influence of season on outcomes following THA is essential when risk-stratifying patients to optimize outcomes and reduce episode of care costs.

Keywords: Hip arthroplasty; Healthcare; Infection; Outcomes; Season

Core tip: Season of the year when a total hip arthroplasty is performed may affect 90-d post-operative outcomes in certain regions of the United States. Furthermore, there appears to be a difference of the effect of seasonal variation on the outcomes as superficial infections have different patterns compared to deep peri-prosthetic joint infection.