The economic impact of periprosthetic infection in total hip arthroplasty
Jason Akindolire, Mina W. Morcos, Jacquelyn D. Marsh, James L. Howard, Brent A. Lanting, Edward M. Vasarhelyi, Jason Akindolire, Mina W. Morcos, Jacquelyn D. Marsh, James L. Howard, Brent A. Lanting, Edward M. Vasarhelyi
Abstract
Background: Periprosthetic joint infection (PJI) is the third leading cause of total hip arthroplasty (THA) failure. Although controversial, 2-stage revision remains the gold standard treatment for PJI in most situations. To date, there have been few studies describing the economic impact of PJI in today’s health care environment. The purpose of the current study was to obtain an accurate estimate of the institutional cost associated with the management of PJI in THA and to assess the economic burden of PJI compared with primary uncomplicated THA.
Methods: We conducted a review of primary THA cases and 2-stage revision THA for PJI at our institution. Patients were matched for age and body mass index. All costs associated with each procedure were recorded. Descriptive statistics were used to summarize the collected data. Mean costs, length of stay, clinic visits and readmission rates associated with the 2 cohorts were compared.
Results: Fifty consecutive cases of revision THA were matched with 50 cases of uncomplicated primary THA between 2006 and 2014. Compared with the primary THA cohort, PJI was associated with a significant increase in mean length of hospital stay (26.5 v. 2.0 d, p < 0.001), mean number of clinic visits (9.2 v. 3.8, p < 0.001), number of readmissions (12 v. 1, p < 0.001) and average overall cost (Can$38 107 v. Can$6764, t = 8.3, p < 0.001).
Conclusion: Treatment of PJI is a tremendous economic burden. Our data suggest a 5-fold increase in hospital expenditure in the management of PJI compared with primary uncomplicated THA.
Conflict of interest statement
J. Howard reports receiving grants from Stryker and DePuy, personal fees from Stryker, DePuy, Smith & Nephew and Intellijoint, and institutional research support from Stryker, DePuy, Smith & Nephew, Zimmer and MicroPort, all outside the submitted work. He holds stock in PersaFix Technologies. B. Lanting reports receiving personal fees from Smith & Nephew, Stryker, DePuy, Integra and Intellijoint, and institutional support from Smith & Nephew, DePuy, Stryker and Zimmer, all outside the submitted work. E. Vasarhelyi reports receiving grants from DePuy, grants and personal fees from DePuy and Hip Innovation Technology, and institutional support from DePuy, Stryker and Smith & Nephew, all outside the submitted work. No other competing interests were declared.
© 2020 Joule Inc. or its licensors
Source: PubMed