Predicting infections after total joint arthroplasty using a prescription based comorbidity measure

Abstract

This study evaluated the association and predictive ability of co-morbidities measured by RxRisk-V, Elixhauser and Charlson measures and post-total hip (THA) and total knee arthroplasties (TKA) infection. THAs and TKAs (2001–2012) were identified using the Australian Department of Veterans’ Affairs data. Infections within 90 days post-surgery were the study endpoint. Co-morbidities were identified using pharmacy (RxRisk-V) and hospitalization history (Elixhauser, Charlson). Of the 11,848 THAs, 3.1% (N = 364) had infections and out of 18,972 TKAs 3.4% (N = 648). Comorbidity burden and specific conditions were associated with infection likelihood. RxRisk-V performed better than other measures, but none had high predictive ability and differences were small. The best performing infection prediction models resulted when a combination of conditions identified by all measures was used.