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Short Operative Duration and Surgical Site Infection Risk in Hip and Knee Arthroplasty Procedures

Published online by Cambridge University Press:  22 September 2015

Kristen V. Dicks ,
Arthur W. Baker ,
Michael J. Durkin ,
Deverick J. Anderson ,
Rebekah W. Moehring ,
Luke F. Chen ,
Daniel J. Sexton ,
David J. Weber  and
Sarah S. Lewis
Kristen V. Dicks*
Affiliation:
Department of Medicine, Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina Duke Infection Control Outreach Network, Durham, North Carolina
Arthur W. Baker
Affiliation:
Department of Medicine, Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina Duke Infection Control Outreach Network, Durham, North Carolina
Michael J. Durkin
Affiliation:
Department of Medicine, Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina Duke Infection Control Outreach Network, Durham, North Carolina
Deverick J. Anderson
Affiliation:
Department of Medicine, Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina Duke Infection Control Outreach Network, Durham, North Carolina
Rebekah W. Moehring
Affiliation:
Department of Medicine, Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina Duke Infection Control Outreach Network, Durham, North Carolina Durham Veterans Affairs Medical Center, Durham, North Carolina
Luke F. Chen
Affiliation:
Department of Medicine, Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina Duke Infection Control Outreach Network, Durham, North Carolina
Daniel J. Sexton
Affiliation:
Department of Medicine, Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina Duke Infection Control Outreach Network, Durham, North Carolina
David J. Weber
Affiliation:
Department of Medicine, Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina
Sarah S. Lewis
Affiliation:
Department of Medicine, Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina Duke Infection Control Outreach Network, Durham, North Carolina
*
Address correspondence to Kristen V. Dicks, MD, PO Box 102359, Department of Medicine, Division of Infectious Diseases, Duke University Medical Center, Durham, NC 27710 ([email protected])
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Abstract

OBJECTIVE

To determine the association (1) between shorter operative duration and surgical site infection (SSI) and (2) between surgeon median operative duration and SSI risk among first-time hip and knee arthroplasties.

DESIGN

Retrospective cohort study

SETTING

A total of 43 community hospitals located in the southeastern United States.

PATIENTS

Adults who developed SSIs according to National Healthcare Safety Network criteria within 365 days of first-time knee or hip arthroplasties performed between January 1, 2008 and December 31, 2012.

METHODS

Log-binomial regression models estimated the association (1) between operative duration and SSI outcome and (2) between surgeon median operative duration and SSI outcome. Hip and knee arthroplasties were evaluated in separate models. Each model was adjusted for American Society of Anesthesiology score and patient age.

RESULTS

A total of 25,531 hip arthroplasties and 42,187 knee arthroplasties were included in the study. The risk of SSI in knee arthroplasties with an operative duration shorter than the 25th percentile was 0.40 times the risk of SSI in knee arthroplasties with an operative duration between the 25th and 75th percentile (risk ratio [RR], 0.40; 95% confidence interval [CI], 0.38–0.56; P<.01). Short operative duration did not demonstrate significant association with SSI for hip arthroplasties (RR, 1.04; 95% CI, 0.79–1.37; P=.36). Knee arthroplasty surgeons with shorter median operative durations had a lower risk of SSI than surgeons with typical median operative durations (RR, 0.52; 95% CI, 0.43–0.64; P<.01).

CONCLUSIONS

Short operative durations were not associated with a higher SSI risk for knee or hip arthroplasty procedures in our analysis.

Infect. Control Hosp. Epidemiol. 2015;36(12):1431–1436

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 36 , Issue 12 , December 2015 , pp. 1431 - 1436
Copyright
© 2015 by The Society for Healthcare Epidemiology of America. All rights reserved 

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