The use of biologic disease-modifying anti-rheumatic drugs does not increase surgical site infection or delayed wound healing after orthopaedic surgeries for rheumatoid arthritis.

IF 1.8 4区 医学 Q3 RHEUMATOLOGY Modern Rheumatology Pub Date : 2024-09-27 DOI:10.1093/mr/roae089
Yohei Kiso, Keiichiro Nishida, Ryozo Harada, Yoshihisa Nasu, Ryuichi Nakahara, Yoshifumi Hotta, Shuichi Naniwa, Toshifumi Ozaki
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Abstract

Objective: To investigate the effect of the use of biologic disease-modifying anti-rheumatic drugs (bDMARDs) on surgical site infection (SSI) and delayed wound healing (DWH) in rheumatoid arthritis (RA) patients undergoing orthopaedic surgery.

Patients and methods: We retrospectively reviewed the records of 965 elective orthopaedic procedures undertaken in RA patients. The incidences of SSI and DWH were compared between the bDMARDs user and non-user groups. Subsequently, univariate and multivariate logistic regression analyses were performed to evaluate risk factors for SSI and DWH after propensity score (PS) matching. The incidence of postoperative flare-up was also examined.

Results: In 965 procedures, SSI and DWH were identified in 12 and 28 cases, respectively. SSI and DWH were identified in 3 and 17 of 414 procedures treated with bDMARDs, respectively. Flare-up occurred in 21 cases. PS matching identified 315 cases in both groups, with no significant difference in incidence between the two groups. No risk factors for SSI were identified, whereas age, diabetes mellitus, foot and ankle surgery and a history of musculoskeletal-related infection were identified as risk factors for DWH.

Conclusion: The use of bDMARDs was not associated with an increased incidence of SSI or DWH, with the incidence of flare-up being relatively low.

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类风湿性关节炎骨科手术后,使用生物制剂改变病情抗风湿药不会增加手术部位感染或延迟伤口愈合。
目的研究类风湿关节炎(RA)患者接受骨科手术时,使用生物制剂改善病情抗风湿药物(bDMARDs)对手术部位感染(SSI)和伤口延迟愈合(DWH)的影响:我们回顾性分析了965例接受骨科手术的RA患者的病历。比较了使用 bDMARDs 组和未使用 bDMARDs 组的 SSI 和 DWH 发生率。随后进行了单变量和多变量逻辑回归分析,以评估倾向评分(PS)匹配后出现 SSI 和 DWH 的风险因素。此外,还对术后复发的发生率进行了研究:结果:在965例手术中,分别有12例和28例发现了SSI和DWH。在使用 bDMARDs 治疗的 414 例手术中,分别有 3 例和 17 例发现 SSI 和 DWH。有 21 例患者病情复发。PS 比对在两组中均发现了 315 例病例,两组的发病率无明显差异。没有发现SSI的危险因素,而年龄、糖尿病、足踝手术和肌肉骨骼相关感染史则是DWH的危险因素:结论:bDMARDs的使用与SSI或DWH发生率的增加无关,且复发率相对较低。
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来源期刊
Modern Rheumatology
Modern Rheumatology RHEUMATOLOGY-
CiteScore
4.90
自引率
9.10%
发文量
146
审稿时长
1.5 months
期刊介绍: Modern Rheumatology publishes original papers in English on research pertinent to rheumatology and associated areas such as pathology, physiology, clinical immunology, microbiology, biochemistry, experimental animal models, pharmacology, and orthopedic surgery. Occasional reviews of topics which may be of wide interest to the readership will be accepted. In addition, concise papers of special scientific importance that represent definitive and original studies will be considered. Modern Rheumatology is currently indexed in Science Citation Index Expanded (SciSearch), Journal Citation Reports/Science Edition, PubMed/Medline, SCOPUS, EMBASE, Chemical Abstracts Service (CAS), Google Scholar, EBSCO, CSA, Academic OneFile, Current Abstracts, Elsevier Biobase, Gale, Health Reference Center Academic, OCLC, SCImago, Summon by Serial Solutions
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