SP5.1.5 Risk factors for Septic Arthritis and need for Arthroscopic Washout: Minimum two year follow-up at a major trauma centre. (9th August 2022)

• Record Type: Journal Article
• Authors: Lu, Victor; Zhou, Andrew; Hussain, Hassan; Thahir, Azeem; Krkovic, Matija
• Is Part Of: British journal of surgery. Volume 109(2022)Supplement 5
• Publication Date: 2022-08-09
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1093/bjs/znac247.051
• Languages: English
• ISSNs: 0007-1323

Abstract

Abstract: Introduction: A hot swollen joint is commonly encountered in orthopaedics and rheumatology. With a broad range of differentials, septic arthritis (SA) is perhaps the most concerning, with delayed treatment leading to osteonecrosis, loss-of-joint-function, and mortality. To facilitate clinical decision making, we aimed to determine the risk factors for development of SA. Methods: All patients presenting to the emergency department, orthopaedic and rheumatology clinics at our major trauma centre between January 2020 and January 2021 with a hot, swollen joint were retrospectively evaluated. The frequency of variables of interest in the three-month period preceding the diagnosis of SA were compared between SA and non-SA patients using univariate analysis. A multiple logistic regression model was formed for covariates that were significantly associated with SA (p<0.05), which underwent a backwards elimination process to identify a predictive model for SA. Multi-collinearity was assessed between covariates and variables with significant intercorrelation were removed. Statistical significance was set at p<0.05. Results: 221 patients were included (SA: 28; periprosthetic joint infection: 24; pseudogout: 32; gout:26; other conditions: 111). Multivariate analysis showed that RA, skin infection, and liver disease were risk factors for SA, with odds ratios of 2.656 (95%CI:1.090–6.475;p=0.032), 3.162 (95:CI:1.269–7.883;p=0.013), 4.993 (95%CI:1.156–21.559;p=0.031), respectively. Conclusion: With a high mortality and morbidity rate, early diagnosis of septic arthritis is crucial. This requires understanding what the risk factors are, namely RA, skin infection, and liver disease. We believe that the models in this study are of prognostic value to clinicians who are presented with the common presenting compliant of a hot swollen joint.