Shoulder periprosthetic joint infection is associated with increased mortality

Periprosthetic joint infections (PJIs) are a catastrophic complication after shoulder arthroplasty and may be associated with an increased mortality risk, as seen in hip and knee arthroplasty. Shoulder PJI organisms differ from hip and knee infections, as lower-virulence organisms, such as Cutibacte...

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Bibliographic Details
Published in:Journal of shoulder and elbow surgery 2023-06, Vol.32 (6), p.S1-S7
Main Authors: Chen, Raymond E., Vaughan, Alayna K., Cox, Ryan M., Alfonsi, Samuel, Belden, Katherine A., Namdari, Surena
Format: Article
Language:English
Subjects:
Arthritis, Infectious - surgery
Arthroplasty, Replacement, Hip
Arthroplasty, Replacement, Knee - adverse effects
aseptic shoulder infection
Humans
Periprosthetic joint infection
Prosthesis-Related Infections - microbiology
Reoperation - methods
Retrospective Studies
revision shoulder arthroplasty
septic shoulder infection
Shoulder - surgery
shoulder arthroplasty mortality
Shoulder Joint - surgery
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Summary:Periprosthetic joint infections (PJIs) are a catastrophic complication after shoulder arthroplasty and may be associated with an increased mortality risk, as seen in hip and knee arthroplasty. Shoulder PJI organisms differ from hip and knee infections, as lower-virulence organisms, such as Cutibacterium acnes, are more commonly encountered. This study evaluated the association between shoulder PJI and mortality. We retrospectively identified 411 patients who underwent revision shoulder arthroplasty from 2007 to 2020 at a single institution. 2018 International Consensus Meeting on Musculoskeletal Infection criteria were used to categorize each case as definite, probable, possible, or unlikely PJI. Mortality rate was assessed by performing chart reviews and an obituary search. Revision cases were grouped into a septic cohort (definite and probable PJI) and an aseptic cohort (possible and unlikely PJI). Kaplan-Meier analyses were performed to compare survival between septic and aseptic groups. The log-rank test was used to compare cumulative survival distributions and survival rates at 90 days, 6 months, 1 year, 2 years, and 5 years. Demographic information, Charlson Comorbidity Index (CCI), and culture data were collected. PJI organisms were categorized as virulent or nonvirulent per an infectious disease specialist, and predictors of mortality were determined by performing stepwise logistic regression analyses. The overall mortality rate was significantly greater (P 
ISSN:1058-2746
1532-6500
DOI:10.1016/j.jse.2023.02.004