September 10, 2018
1 min read

SSIs following hip, knee replacements will increase by 14% if HHS goal not met

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Unless rates are reduced, researchers predict that surgical site infections following knee and hip arthroplasties will increase by 14% between 2020 and 2030 in the United States.

“Hip and knee arthroplasties improve the quality of life for patients who receive elective surgery,” Hannah M. Wolford, MSPH, and colleagues from the CDC’s Division of Healthcare Quality Promotion wrote in Infection Control & Hospital Epidemiology. “The demand for arthroplasty is anticipated to increase due to the aging U.S. population and projected increases in obesity prevalence, leading to a concomitant increase in the incidence of [surgical site infections (SSIs)].”

According to Wolford and colleagues, as of 2009, for every 1,000 hip and knee arthroplasties, roughly 6.9 patients developed a complex SSI, which are associated with an increased perioperative mortality rate, longer length of stay, higher cost of hospital care and additional procedures to address the infection.

To reduce these burdens, HHS established a goal to lower SSI rates by 30% by 2020. Wolford and colleagues assessed the potential impact of achieving the HHS goal while accounting for underlying time trends in population counts, and projected primary and revision hip and knee arthroplasty SSIs using estimated and targeted SSI rates from 2020 through 2030.

Primary arthroplasty rates were calculated using annual estimates of hip and knee arthroplasty stratified by age and gender from the 2012-2014 Nationwide Inpatient Sample and standardized by census population data. Revision rates were obtained from published literature and were uniformly applied for all ages and genders. Wolford and colleagues recalculated the projections with an SSI rate reduced by 30% to evaluate the possible impact of the HHS initiative.

The study determined that without the reduction in SSIs aligning with the HHS initiative, there will be a 14% increase in complex SSIs between 2020 and 2030, with a total of 15,820,475 hip and knee arthroplasties with a projected burden of 77,653 SSIs. Meeting HHS’s 30% reduction goal could prevent 23,297 of these infections.

“Our model demonstrates that even with stable arthroplasty and SSI rates, demographic changes in the U.S. population will result in more arthroplasties and SSIs, as well as an increased public health burden,” Wolford and colleagues concluded. – by Caitlyn Stulpin

Disclosures: The authors report no relevant financial disclosures.