Patient, Surgery, and Hospital Related Risk Factors for Surgical Site Infections following Total Hip Arthroplasty

Table 1

Studies of risk factors for surgical site infection in patients undergoing total hip arthroplasty (THA).

Study	Type	Number of THAs	Risk factors identified
Berbari et al. [42]	Retrospective	526	Superficial surgical site infection, NNIS index score ≥1, malignancy, prior arthroplasty.
Bongartz et al. [37]	Retrospective	328	Revision surgery, prolonged duration of surgery, previous joint infection, and rheumatoid arthritis.
Bozic et al. [19]	Retrospective	40,919	Obesity, rheumatologic disease, coagulopathy, and preoperative anemia.
Bozic et al. [63]	Retrospective	57,047 THAs with different bearing surfaces	Metal-on-metal bearing surfaces.
Carroll et al. [17]	Retrospective	453	Obesity, allogeneic blood transfusion, coagulation with warfarin, and surgical skin preparation with 0.5% chlorhexidine in 70% alcohol.
Choong et al. [20]	Retrospective	819	Obesity and presence of >2 comorbidities.
Cordero-Ampuero; and de Dios [8]	Retrospective	47	Older age, systemic corticosteroid treatment, prolonged duration of surgery, trauma, malignancy, liver disease, alcohol abuse, IV drug abuse, inadequate antibiotic prophylaxis, persistent wound secretion, dislocation, skin infection, urinary tract infection, abdominal infection, and pneumonia.
Dale et al. [11]	Retrospective	432,168	Trauma, male gender, hybrid fixation, cement without antibiotics, inflammatory arthritis, and avascular necrosis.
Dowsey and Choong [21]	Retrospective	1,207	Obesity.
Font-Vizcarra et al. [26]	Prospective	402	BMI ≥ 35.
Friedman et al. [22]	Retrospective	12,355	Obesity.
Geubbels et al. [69]	Prospective	13,608 THAs and hemiarthroplasties	Low annual institution volume.
Gilson et al. [39]	Retrospective	22 patients receiving TNFa blockers subjected to hip, knee, shoulder, and ankle arthroplasty	Treatment with TNFa blockers.
Smith et al. [53]	Prospective	308 THAs and TKAs	Allogeneic WBC-filtered blood transfusion.
Iorio et al. [35]	Retrospective	1,659	Diabetes.
Jafari et al. [45]	Retrospective	55 THAs and TKAs	Previous joint infection.
Jiang et al. [43]	Retrospective	878 THAs	Liver cirrhosis.
Katz et al. [70]	Retrospective	58,521	Low institution volume and low surgeon volume.
Lai et al. [31]	Retrospective	22	Diabetes and presence of >2 comorbidities.
Lee et al. [72]	Retrospective	74	Admission from a healthcare facility.
Malinzak et al. [9]	Retrospective	2,775	Younger age, diabetes, and obesity.
Maoz et al. [23]	Retrospective	3,672 primary THAs, 406 revision THAs	Obesity, revision surgery, prolonged duration of surgery, and non-same day surgery.
McDougall et al. [59]	Retrospective	1,047	Anticoagulation with warfarin or IV heparin.
Momohara et al. [38]	Retrospective	81	Treatment with TNFa blockers and longer duration of rheumatoid arthritis.
Mraovic et al. [24]	Retrospective	101 THAs and TKAs versus 1,847 controls	Diabetes, obesity, prolonged duration of surgery, presence of >2 comorbidities, history of myocardial infarction, congestive heart failure, and renal insufficiency.
Muilwijk et al. [71]	Retrospective	15,906	Low surgeon volume.
Namba et al. [14]	Retrospective	30,491	Obesity, female gender, ASA score ≥3, and bilateral THAs.
Newman et al. [55]	Retrospective	1,622	Allogeneic blood transfusion.
Ong et al. [12]	Retrospective	39,929	Prolonged duration of surgery, Charlson index >5, male gender, and lower socioeconomic status.
Parvizi et al. [60]	Retrospective	35	INR > 1.5.
Patel et al. [27]	Retrospective	1,221	Obesity, coagulation with LMWH, and increased drain tube loss.
Peel et al. [18]	Prospective	36	Obesity, superficial surgical site infection, increased drain tube loss, and systemic corticosteroid treatment.
Poultsides et al. [10]	Retrospective	412,356	Malignancy, coagulopathy, liver disease, male gender, congestive heart failure, fluid and electrolyte disorders, pulmonary circulatory disease, and minority race.
Pulido et al. [25]	Retrospective	5,060	Obesity, allogeneic blood transfusion, urinary tract infection, history of myocardial infarction, renal insufficiency, bilateral THAs, postoperative atrial fibrillation, and prolonged hospitalization.
Ridgeway et al. [6]	Prospective	16,291 primary THAs, 2,550 revision THAs	Older age, prolonged duration of surgery, trauma, and ASA score ≥3.
Saleh et al. [28]	Prospective	33 THAs and TKAs	Hematoma formation and persistent drainage.
Song et al. [34]	Retrospective	3,422	Diabetes, revision surgery, prolonged duration of surgery, and trauma.
Sousa et al. [49]	Prospective	1,248 THAs	Asymptomatic bacteriuria.
van Kasteren et al. [30]	Prospective	1,922	Prolonged duration of surgery, ASA score ≥3, and administration of prophylactic antibiotics after incision.
Willis-Owen et al. [13]	Prospective	1,750	Male gender and prolonged duration of surgery.
Wu et al. [7]	Retrospective	198	Older age, diabetes, obesity, alcohol abuse, and rural residence.