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Infections after shoulder arthroplasty are correlated with higher anesthetic risk score: a case-control study in Brazil

Overview of attention for article published in Brazilian Journal of Infectious Diseases, November 2017
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Title
Infections after shoulder arthroplasty are correlated with higher anesthetic risk score: a case-control study in Brazil
Published in
Brazilian Journal of Infectious Diseases, November 2017
DOI 10.1016/j.bjid.2017.06.003
Pubmed ID
Authors

Leonardo Hideto Nagaya, Mauro José Costa Salles, Lucas Sadawo Chagas Takikawa, Marcelo Fregoneze, Pedro Doneux, Luciana Andrade da Silva, Guilherme do Val Sella, Alberto Naoki Miyazaki, Sergio Luiz Checchia

Abstract

Shoulder arthroplasty (SA) has been performed by many years for the treatment of several conditions, including osteoarthritis and proximal humeral fractures following trauma. Surgical site infection (SSI) following SA remains a challenge, contributing to increased morbidity and costs. Identification of risk factors may help implementing adequate strategies to prevent infection. We aimed to identify pre- and intra-operative risk factors associated with deep infections after SA. An unmatched case-control study was conducted to describe the prevalence, clinical and microbiological findings, and to evaluate patient and surgical risk factors for prosthetic shoulder infection (PSI), among 158 patients who underwent SA due to any reason, at a tertiary public university institution. Risk factors for PSI was assessed by uni- and multivariate analyses using multiple logistic regression. 168 SA from 158 patients were analyzed, with an overall infection rate of 9.5% (16/168 cases). Subjects undergoing SA with American Society of Anesthesiologists (ASA) grade III or higher (odds ratio [OR]=5.30, 95% confidence interval [CI]=1.58-17.79, p<0.013) and presenting local hematoma after surgery (odds ratio [OR]=7.10, 95% confidence interval [CI]=1.09-46.09, p=0.04) had higher risk for PSI on univariate analysis. However, only ASA score grade III or higher remained significant on multivariate analysis (OR=4.74, 95% CI=1.33-16.92, p=0.016). Gram-positive cocci and Gram-negative bacilli were equally isolated in 50% of cases; however, the most commonly detected bacterium was Pseudomonas aeruginosa (18.7%). This study provides evidence suggesting that patient-related known factors such as higher ASA score predisposes to shoulder arthroplasty-associated infection. Furthermore, unusual pathogens associated with PSI were identified.

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Mendeley readers

The data shown below were compiled from readership statistics for 39 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 39 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 5 13%
Other 4 10%
Professor > Associate Professor 3 8%
Student > Postgraduate 3 8%
Professor 2 5%
Other 7 18%
Unknown 15 38%
Readers by discipline Count As %
Medicine and Dentistry 13 33%
Engineering 5 13%
Pharmacology, Toxicology and Pharmaceutical Science 2 5%
Nursing and Health Professions 1 3%
Agricultural and Biological Sciences 1 3%
Other 2 5%
Unknown 15 38%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 14 July 2017.
All research outputs
#13,645,635
of 15,466,991 outputs
Outputs from Brazilian Journal of Infectious Diseases
#354
of 464 outputs
Outputs of similar age
#226,745
of 266,685 outputs
Outputs of similar age from Brazilian Journal of Infectious Diseases
#5
of 9 outputs
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