The accuracy of reporting of periprosthetic joint infection to the Australian Orthopaedic Association National Joint Replacement Registry. (5th May 2022)

• Record Type: Journal Article
• Authors: Sinagra, Zachary P.; Davis, Joshua S.; Lorimer, Michelle; de Steiger, Richard N.; Graves, Stephen E.; Yates, Piers; Manning, Laurens
• Is Part Of: Bone & joint open. Volume 3:Number 5(2022)
• Page Start: 367
• Page End: 374
• Publication Date: 2022-05-05
• Subjects: Arthroplasty -- Prosthetic Joint Infection -- Reporting Accuracy -- Registry -- Australian Orthopaedic Association National Joint Replacement Registry -- periprosthetic joint infection (PJI) -- Other infections -- arthroplasty registries -- reoperations -- debridement -- joint registries -- multivariate logistic regression analysis -- arthroplasty surgery -- Debridement, antibiotics, and implant retention; Orthopedic surgery -- Periodicals; Musculoskeletal system -- Surgery -- Periodicals; 617.47
• DOI: 10.1302/2633-1462.35.BJO-2022-0011.R1
• Languages: English
• ISSNs: 2633-1462

Abstract

Abstract : Aims: National joint registries under-report revisions for periprosthetic joint infection (PJI). We aimed to validate PJI reporting to the Australian Orthopaedic Association National Joint Arthroplasty Registry (AOANJRR) and the factors associated with its accuracy. We then applied these data to refine estimates of the total national burden of PJI. Methods: A total of 561 Australian cases of confirmed PJI were captured by a large, prospective observational study, and matched to data available for the same patients through the AOANJRR. Results: In all, 501 (89.3%) cases of PJI recruited to the prospective observational study were successfully matched with the AOANJRR database. Of these, 376 (75.0%) were captured by the registry, while 125 (25.0%) did not have a revision or reoperation for PJI recorded. In a multivariate logistic regression analysis, early (within 30 days of implantation) PJIs were less likely to be reported (adjusted odds ratio (OR) 0.56; 95% confidence interval (CI) 0.34 to 0.93; p = 0.020), while two-stage revision procedures were more likely to be reported as a PJI to the registry (OR 5.3 (95% CI 2.37 to 14.0); p ≤ 0.001) than debridement and implant retention or other surgical procedures. Based on this data, the true estimate of the incidence of PJI in Australia is up to 3, 900 cases per year. Conclusion: In Australia, infection was not recorded as the indication for revision or reoperation in one-quarter of those with confirmed PJI. This is better than in other registries, but suggests that registry-captured estimates of the total national burden of PJI are underestimated by at least one-third. Inconsistent PJI reporting is multifactorial but could be improved by developing a nested PJI registry embedded within the national arthroplasty registry. Cite this article: Bone Jt Open 2022;3(5):367–373.