Background.Urinary tract infections (UTIs) are the most common minor complication following total joint arthroplasty (TJA) with\nincidence as high as 3.26%. Bladder catheterization is routinely used during TJAand theCenters forMedicare andMedicaid Services\n(CMS) has recently identified hospital-acquired catheter associated UTI as a target for quality improvement. This investigation\nseeks to identify specific risk factors for UTI in TJA patients. Methods. We retrospectively studied patients undergoing TJA for\nosteoarthritis between 2006 and 2013 in the American College of Surgeonââ?¬â?¢s National Surgical Improvement Program Database\n(ACS-NSQIP). A univariate analysis screen followed by multivariate logistic regression identified specific patient demographics,\ncomorbidities, preoperative laboratory values, and operative characteristics independently associated with postoperative UTI.\nResults. 1,239 (1.1%) of 115,630 TJA patients we identified experienced a postoperative UTI. The following characteristics are\nindependently associated with postoperative UTI: female sex (OR 2.1, 95% CI 1.6ââ?¬â??2.7), chronic steroid use (OR 2.0, 95% CI 1.2ââ?¬â??3.2),\nages 60ââ?¬â??69 (OR 1.5, 95% CI 1.0ââ?¬â??2.1), 70ââ?¬â??79 (OR 2.0, 95% CI 1.4ââ?¬â??2.9), and ââ?°Â¥80 (OR 2.3, 95% CI 1.5ââ?¬â??3.6), ASA Classes 3ââ?¬â??5 (OR 1.5,\n95% CI 1.2ââ?¬â??1.9), preoperative creatinine >1.35 (OR 1.8, 95% CI 1.3ââ?¬â??2.6), and operation time greater than 130 minutes (OR 1.8, 95% CI\n1.3ââ?¬â??2.4). Conclusions. In this large database query, postoperative UTI occurs in 1.1% of patients following TJA and several variables\nincluding female sex, age greater than 60, and chronic steroid use are independent risk factors for occurrence. Practitioners should\nbe aware of populations at greater risk to support efforts to comply with CMS initiated quality improvement.
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