دورية أكاديمية
أعرض في EDS

Preoperative Corticosteroid Injections Within 4 Weeks of Arthroscopic Shoulder Procedures Are Associated With Increased Postoperative Infection Rates.

التفاصيل البيبلوغرافية
العنوان: Preoperative Corticosteroid Injections Within 4 Weeks of Arthroscopic Shoulder Procedures Are Associated With Increased Postoperative Infection Rates.
المؤلفون: Remily E; Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland, U.S.A., Dubin J; Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland, U.S.A., Bains SS; Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland, U.S.A., Monarrez R; Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland, U.S.A., Livesey MG; Department of Orthopaedic Surgery, University of Maryland, Baltimore, Maryland, U.S.A., Weir TB; Department of Orthopaedic Surgery, University of Maryland, Baltimore, Maryland, U.S.A., Hameed D; Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland, U.S.A., Ingari JV; Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland, U.S.A., Gilotra MN; Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland, U.S.A., Hasan SA; Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland, U.S.A.. Electronic address: Ahasan@som.umaryland.edu.
المصدر: Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association [Arthroscopy] 2024 Feb; Vol. 40 (2), pp. 277-283.e1. Date of Electronic Publication: 2023 Sep 07.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: W.B. Saunders Co Country of Publication: United States NLM ID: 8506498 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1526-3231 (Electronic) Linking ISSN: 07498063 NLM ISO Abbreviation: Arthroscopy Subsets: MEDLINE
أسماء مطبوعة: Publication: Philadelphia, PA : W.B. Saunders Co.
Original Publication: [New York, N.Y.] : Raven Press, [c1985-
مواضيع طبية MeSH: Shoulder*/surgery , Arthroscopy*/adverse effects , Arthroscopy*/methods, Humans ; Retrospective Studies ; Surgical Wound Infection/epidemiology ; Surgical Wound Infection/etiology ; Injections, Intra-Articular/adverse effects ; Adrenal Cortex Hormones/adverse effects ; Postoperative Complications/etiology
مستخلص: Purpose: To refine the understanding of the effect of timing of corticosteroid injections (CSIs) and shoulder arthroscopy on postoperative infection.
Methods: An insurance database was used to determine all patients who underwent shoulder arthroscopy for a 5-year period with an associated preoperative ipsilateral corticosteroid injection. Patients were stratified into cohorts based on timing of preoperative CSI: (1) 0-<2 weeks, (2) 2-<4 weeks, (3) 4-<6 weeks, and (4) 6-<8 weeks. Patients were pooled to include all patients who had a CSI less than 4 weeks and those longer than 4 weeks. A cohort of patients who never had a corticosteroid injection before undergoing arthroscopy were used as a control. All patients had a follow-up of 2 years. Multivariable regression analyses were performed using R Studio with significance defined as P < .05.
Results: Multivariate logistic regression showed a greater odds ratio (OR) for postoperative infection in patients who received CSI 0-<2 weeks before shoulder arthroscopy at 90 days (3.10, 95% confidence interval [CI] 1.62-5.57, P < .001), 1 year (2.51, 95% CI 1.46-4.12, P < .001), and 2 years (2.08, 95% CI 1.27-3.28, P = .002) compared with the control group. Patients who received CSI 2-<4 weeks before shoulder arthroscopy had greater OR for infection at 90 days (2.26, 95% CI 1.28-3.83, P = .03), 1 year (1.82, 95% CI 1.13-2,82, P = .01), and 2 years (1.62, 95% CI 1.10-2.47, P = .012). Patients who received CSI after 4 weeks had similar ORs of infection at 90 days (OR 1.15, 95% CI 0.78-1.69, P = .48) 1 year (OR 1.18, 95% CI 0.85-1.63 P = .33), and 2 years (OR 1.09, 95% CI 0.83-1.42, P = .54), compared with the control cohort.
Conclusions: The present study shows the postoperative infection risk is greatest when CSIs are given within 2 weeks of shoulder arthroscopy, whereas CSIs given within 2-<4 weeks also portend increased risk, albeit to a lesser degree. The risk of postoperative infection is not significantly increased when CSIs are given more than 1 month before surgery.
Level of Evidence: Level III, retrospective comparative, prognosis study.
(Copyright © 2023 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.)
التعليقات: Comment in: Arthroscopy. 2024 Feb;40(2):284-286. (PMID: 38296435)
المشرفين على المادة: 0 (Adrenal Cortex Hormones)
تواريخ الأحداث: Date Created: 20230909 Date Completed: 20240202 Latest Revision: 20240226
رمز التحديث: 20240227
DOI: 10.1016/j.arthro.2023.08.073
PMID: 37689159
قاعدة البيانات: MEDLINE
الوصف
تدمد:1526-3231
DOI:10.1016/j.arthro.2023.08.073