TY - JOUR
T1 - Sarcopenia as a Risk Factor for Prosthetic Infection After Total Hip or Knee Arthroplasty
AU - Babu, Jacob M.
AU - Kalagara, Saisanjana
AU - Durand, Wesley
AU - Antoci, Valentin
AU - Deren, Matthew E.
AU - Cohen, Eric
N1 - Publisher Copyright:
© 2018 Elsevier Inc.
PY - 2019/1
Y1 - 2019/1
N2 - Background: Sarcopenia, an age-related loss of muscle mass and function, has been previously linked to an increased risk of morbidity, mortality, and infection after a variety of surgical procedures. This study is the first to evaluate the impact of the psoas-lumbar vertebral index (PLVI), a validated marker for central sarcopenia, on determining post-arthroplasty infection status. Methods: This is a case-control, retrospective review of 30 patients with prosthetic joint infection (PJI) diagnosed by the Musculoskeletal Infection Society criteria compared to 69 control patients who underwent a total hip or knee arthroplasty. All patients had a recent computed tomography scan of the abdomen/pelvis to calculate the PLVI. PLVI was evaluated alongside age, gender, body mass index, Charlson Comorbidity Index, American Society of Anesthesiologists score, and smoking status to determine the predictive value for infection. Results: Notably, the infected group had a large, significant difference in their average PLVI (0.736 vs 0.963, P <.001). The patient's PLVI was a predictor of infection status, with a higher PLVI being protective against infection (odds ratio [OR] 0.28, 95% confidence interval [CI] 0.109-0.715, P =.008). Additional predictors of infection status were higher American Society of Anesthesiologists score (OR 10.634, 95% CI 3.112-36.345, P <.001) and Charlson Comorbidity Index (OR 1.438, 95% CI 1.155-1.791, P =.001). Multivariate, binary logistic regression analysis confirmed that PLVI was a significant independent predictor of infection status (B = −0.685, P =.039). Conclusion: PLVI, a marker for central sarcopenia, was demonstrated to be a risk factor for PJI. Further research and consideration of sarcopenia as a screening and optimizable risk factor for total joint arthroplasty must be explored.
AB - Background: Sarcopenia, an age-related loss of muscle mass and function, has been previously linked to an increased risk of morbidity, mortality, and infection after a variety of surgical procedures. This study is the first to evaluate the impact of the psoas-lumbar vertebral index (PLVI), a validated marker for central sarcopenia, on determining post-arthroplasty infection status. Methods: This is a case-control, retrospective review of 30 patients with prosthetic joint infection (PJI) diagnosed by the Musculoskeletal Infection Society criteria compared to 69 control patients who underwent a total hip or knee arthroplasty. All patients had a recent computed tomography scan of the abdomen/pelvis to calculate the PLVI. PLVI was evaluated alongside age, gender, body mass index, Charlson Comorbidity Index, American Society of Anesthesiologists score, and smoking status to determine the predictive value for infection. Results: Notably, the infected group had a large, significant difference in their average PLVI (0.736 vs 0.963, P <.001). The patient's PLVI was a predictor of infection status, with a higher PLVI being protective against infection (odds ratio [OR] 0.28, 95% confidence interval [CI] 0.109-0.715, P =.008). Additional predictors of infection status were higher American Society of Anesthesiologists score (OR 10.634, 95% CI 3.112-36.345, P <.001) and Charlson Comorbidity Index (OR 1.438, 95% CI 1.155-1.791, P =.001). Multivariate, binary logistic regression analysis confirmed that PLVI was a significant independent predictor of infection status (B = −0.685, P =.039). Conclusion: PLVI, a marker for central sarcopenia, was demonstrated to be a risk factor for PJI. Further research and consideration of sarcopenia as a screening and optimizable risk factor for total joint arthroplasty must be explored.
KW - arthroplasty
KW - prosthetic joint infection
KW - psoas-lumbar vertebral index
KW - risk-factor
KW - sarcopenia
KW - screening
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U2 - 10.1016/j.arth.2018.09.037
DO - 10.1016/j.arth.2018.09.037
M3 - Article
C2 - 30337254
AN - SCOPUS:85054711839
SN - 0883-5403
VL - 34
SP - 116
EP - 122
JO - Journal of Arthroplasty
JF - Journal of Arthroplasty
IS - 1
ER -