Systematic review of risk prediction scores for surgical site infection or periprosthetic joint infection following joint arthroplasty

• Published in: Epidemiology and infection Vol. 145; no. 9; pp. 1738 - 1749
• Main Authors: KUNUTSOR, S. K., WHITEHOUSE, M. R., BLOM, A. W., BESWICK, A. D.
• Format: Journal Article
• Language: English
• Published: England Cambridge University Press 01.07.2017
• Subjects: Arthroplasty; Arthroplasty, Replacement, Hip - adverse effects; Arthroplasty, Replacement, Knee - adverse effects; Biomedical materials; Decisions; Disease; Disease prevention; Epidemiology; Hai; Health care; Hip; Humans; Infections; Infectious diseases; Joint diseases; Joint surgery; Knee; Lists; Mathematical models; Performance prediction; Prediction models; Prosthesis-Related Infections - epidemiology; Registers; Review; REVIEW ARTICLE; Reviews; Risk; Risk Factors; Safety; Studies; Surgery; Surgical implants; Surgical instruments; Surgical site infections; Surgical Wound Infection - epidemiology; Bone infections; epidemiology; risk assessment
• ISSN: 0950-2688; 1469-4409
• DOI: 10.1017/S0950268817000486

Accurate identification of individuals at high risk of surgical site infections (SSIs) or periprosthetic joint infections (PJIs) influences clinical decisions and development of preventive strategies. We aimed to determine progress in the development and validation of risk prediction models for SSI or PJI using a systematic review. We searched for studies that have developed or validated a risk prediction tool for SSI or PJI following joint replacement in MEDLINE, EMBASE, Web of Science and Cochrane databases; trial registers and reference lists of studies up to September 2016. Nine studies describing 16 risk scores for SSI or PJI were identified. The number of component variables in a risk score ranged from 4 to 45. The C-index ranged from 0·56 to 0·74, with only three risk scores reporting a discriminative ability of >0·70. Five risk scores were validated internally. The National Healthcare Safety Network SSIs risk models for hip and knee arthroplasties (HPRO and KPRO) were the only scores to be externally validated. Except for HPRO which shows some promise for use in a clinical setting (based on predictive performance and external validation), none of the identified risk scores can be considered ready for use. Further research is urgently warranted within the field.