Please use this identifier to cite or link to this item: https://hdl.handle.net/20.500.12530/37169
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dc.contributor.authorKunutsor, Setor K
dc.contributor.authorWhitehouse, Michael R
dc.contributor.authorBlom, Ashley W
dc.contributor.authorBoard, Tim
dc.contributor.authorKay, Peter
dc.contributor.authorWroblewski, B Mike
dc.contributor.authorZeller, Valérie
dc.contributor.authorChen, Szu-Yuan
dc.contributor.authorHsieh, Pang-Hsin
dc.contributor.authorMasri, Bassam A
dc.contributor.authorHerman, Amir
dc.contributor.authorJenny, Jean-Yves
dc.contributor.authorSchwarzkopf, Ran
dc.contributor.authorWhittaker, John-Paul
dc.contributor.authorBurston, Ben
dc.contributor.authorHuang, Ronald
dc.contributor.authorRestrepo, Camilo
dc.contributor.authorParvizi, Javad
dc.contributor.authorRudelli, Sergio
dc.contributor.authorHonda, Emerson
dc.contributor.authorUip, David E
dc.contributor.authorBori, Guillem
dc.contributor.authorMuñoz-Mahamud, Ernesto
dc.contributor.authorDarley, Elizabeth
dc.contributor.authorRibera, Alba
dc.contributor.authorCañas, Elena
dc.contributor.authorCabo, Javier
dc.contributor.authorCordero-Ampuero, José
dc.contributor.authorRedó, Maria Luisa Sorlí
dc.contributor.authorStrange, Simon
dc.contributor.authorLenguerrand, Erik
dc.contributor.authorGooberman-Hill, Rachael
dc.contributor.authorWebb, Jason
dc.contributor.authorMacGowan, Alasdair
dc.contributor.authorDieppe, Paul
dc.contributor.authorWilson, Matthew
dc.contributor.authorBeswick, Andrew D
dc.date.accessioned2019-06-28T18:26:47Z-
dc.date.available2019-06-28T18:26:47Z-
dc.date.issued2018-10
dc.identifier.citationEur. J. Epidemiol..2018 Oct;(33)10:933-946
dc.identifier.urihttps://hdl.handle.net/20.500.12530/37169-
dc.description.abstractOne-stage and two-stage revision strategies are the two main options for treating established chronic peri-prosthetic joint infection (PJI) of the hip; however, there is uncertainty regarding which is the best treatment option. We aimed to compare the risk of re-infection between the two revision strategies using pooled individual participant data (IPD). Observational cohort studies with PJI of the hip treated exclusively by one- or two-stage revision and reporting re-infection outcomes were retrieved by searching MEDLINE, EMBASE, Web of Science, The Cochrane Library, and the WHO International Clinical Trials Registry Platform; as well as email contact with investigators. We analysed IPD of 1856 participants with PJI of the hip from 44 cohorts across four continents. The primary outcome was re-infection (recurrence of infection by the same organism(s) and/or re-infection with a new organism(s)). Hazard ratios (HRs) for re-infection were calculated using Cox proportional frailty hazards models. After a median follow-up of 3.7 years, 222 re-infections were recorded. Re-infection rates per 1000 person-years of follow-up were 16.8 (95% CI 13.6-20.7) and 32.3 (95% CI 27.3-38.3) for one-stage and two-stage strategies respectively. The age- and sex-adjusted HR of re-infection for two-stage revision was 1.70 (0.58-5.00) when compared with one-stage revision. The association remained consistently absent after further adjustment for potential confounders. The HRs did not vary importantly in clinically relevant subgroups. Analysis of pooled individual patient data suggest that a one-stage revision strategy may be as effective as a two-stage revision strategy in treating PJI of the hip.
dc.language.isoeng
dc.rightsopenAccess-
dc.subjectMeta-analysis
dc.subjectOne-stage
dc.subjectProsthesis related infection
dc.subjectRe-infection
dc.subjectReoperation
dc.subjectRevision
dc.subjectTotal hip replacement
dc.subjectTwo-stage
dc.subject.meshAged
dc.subject.meshArthroplasty, Replacement, Hip
dc.subject.meshCohort Studies
dc.subject.meshFemale
dc.subject.meshHip Prosthesis
dc.subject.meshHumans
dc.subject.meshInfection
dc.subject.meshMale
dc.subject.meshMiddle Aged
dc.subject.meshPostoperative Complications
dc.subject.meshProportional Hazards Models
dc.subject.meshProsthesis-Related Infections
dc.subject.meshReoperation
dc.subject.meshTreatment Outcome
dc.titleOne- and two-stage surgical revision of peri-prosthetic joint infection of the hip: a pooled individual participant data analysis of 44 cohort studies.
dc.typeArtículo
dc.identifier.pubmedID29623671
dc.format.volume33
dc.format.page933-946
dc.identifier.e-issn1573-7284
dc.identifier.journalEuropean journal of epidemiology
dc.identifier.doi10.1007/s10654-018-0377-9
dc.format.number10
dc.identifier.pmcPMC6153557
dc.pubmedtypeJournal Article
dc.pubmedtypeMeta-Analysis
Appears in Collections:Fundaciones e Institutos de Investigación > IIS H. U. La Princesa > Artículos

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