{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:31:35Z","timestamp":1787754695640,"version":"build-2784847793"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"18","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery"],"published-print":{"date-parts":[[2016,9,21]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Surgical site infection (SSI) is a major complication following total joint arthroplasty. Host susceptibility to infection has emerged as an important predictor of SSI. The purpose of this study was to develop and validate a preoperative SSI risk-assessment tool for primary or revision knee and hip arthroplasty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Data for 6,789 patients who underwent total joint arthroplasty (from the years 2000 to 2011) were obtained from a single hospital system. SSI was defined as a superficial infection within 30 days or deep infection within 1 year. Logistic regression modeling was utilized to create a risk scoring system for a derivation sample (n = 5,789; 199 SSIs), with validation performed on a hold-out sample (a subset of observations chosen randomly from the initial sample to form a testing set; n = 1,000; 41 SSIs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>On the basis of logistic regression modeling, we created a scoring system to assess SSI risk (range, 0 to 35 points) that is the point sum of the following: primary hip arthroplasty (0 points); primary knee (1); revision hip (3); revision knee (3); non-insulin-dependent diabetes (1); insulin-dependent diabetes (1.5); chronic obstructive pulmonary disease (COPD) (1); inflammatory arthropathy (1.5); tobacco use (1.5); lower-extremity osteomyelitis or pyogenic arthritis (2); pelvis, thigh, or leg traumatic fracture (2); lower-extremity pathologic fracture (2.5); morbid obesity (2.5); primary bone cancer (4); reaction to prosthesis in the last 3 years (4); and history of staphylococcal septicemia (4.5). The risk score had good discriminatory capability (area under the ROC [receiver operating characteristic] curve = 0.77) and calibration (Hosmer-Lemeshow chi-square test, p = 0.34) and was validated using the independent sample (area under the ROC curve = 0.72). A small subset of patients (5.9%) had a &gt;10% estimated infection risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The patient comorbidities composing the risk score heavily influenced SSI risk for primary or revision knee and hip arthroplasty. We believe that infection risk can be objectively determined in a preoperative setting with the proposed SSI risk score.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.15.00988","type":"journal-article","created":{"date-parts":[[2016,9,21]],"date-time":"2016-09-21T13:53:22Z","timestamp":1474466002000},"page":"1522-1532","source":"Crossref","is-referenced-by-count":45,"title":["Development and Validation of a Preoperative Surgical Site Infection Risk Score for Primary or Revision Knee and Hip Arthroplasty"],"prefix":"10.2106","volume":"98","author":[{"given":"Joshua S.","family":"Everhart","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Wexner Medical Center, The Ohio State University, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca R.","family":"Andridge","sequence":"additional","affiliation":[{"name":"Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas J.","family":"Scharschmidt","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Wexner Medical Center, The Ohio State University, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel L.","family":"Mayerson","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Wexner Medical Center, The Ohio State University, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew H.","family":"Glassman","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Wexner Medical Center, The Ohio State University, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stanley","family":"Lemeshow","sequence":"additional","affiliation":[{"name":"Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"6","key":"bib2-20230714","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.arth.2009.05.016","article-title":"Morbidly obese, diabetic, younger, and unilateral joint arthroplasty patients have elevated total joint arthroplasty infection rates","volume":"24","author":"Malinzak","year":"2009","journal-title":"J Arthroplasty."},{"issue":"4","key":"bib3-20230714","doi-asserted-by":"crossref","first-page":"871","DOI":"10.2106\/00004623-200704000-00026","article-title":"Antibiotic-impregnated cement spacers for the treatment of infection associated with total hip or knee arthroplasty","volume":"89","author":"Cui","year":"2007","journal-title":"J Bone Joint Surg Am."},{"issue":"3","key":"bib4-20230714","doi-asserted-by":"crossref","first-page":"149","DOI":"10.3928\/01477447-20100129-09","article-title":"Outcome of infected total joint replacement","volume":"33","author":"Ritter","year":"2010","journal-title":"Orthopedics."},{"issue":"3B","key":"bib5-20230714","doi-asserted-by":"crossref","first-page":"170S","DOI":"10.1016\/0002-9343(91)90364-4","article-title":"Analysis of risk factors for surgical wound infections following vascular surgery","volume":"91","author":"Richet","year":"1991","journal-title":"Am J Med."},{"issue":"6","key":"bib6-20230714","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1086\/502425","article-title":"Risk factors for surgical-site infection following primary total knee arthroplasty","volume":"25","author":"Minnema","year":"2004","journal-title":"Infect Control Hosp Epidemiol."},{"issue":"6","key":"bib7-20230714","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1086\/502424","article-title":"Surgical-site infection rates and risk factor analysis in coronary artery bypass graft surgery","volume":"25","author":"Harrington","year":"2004","journal-title":"Infect Control Hosp Epidemiol."},{"key":"bib8-20230714","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1186\/1749-8090-6-151","article-title":"Are there independent predisposing factors for postoperative infections following open heart surgery?","volume":"6","author":"Lola","year":"2011","journal-title":"J Cardiothorac Surg."},{"key":"bib9-20230714","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1097\/01.blo.0000088564.81746.62","article-title":"A clinical staging system for adult osteomyelitis","volume":"414","author":"Cierny","year":"2003","journal-title":"Clin Orthop Relat Res."},{"issue":"7","key":"bib10-20230714","doi-asserted-by":"crossref","first-page":"1710","DOI":"10.1007\/s11999-008-0209-4","article-title":"Periprosthetic joint infection: the incidence, timing, and predisposing factors","volume":"466","author":"Pulido","year":"2008","journal-title":"Clin Orthop Relat Res."},{"issue":"5","key":"bib11-20230714","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1016\/j.arth.2006.09.002","article-title":"Presence of medical comorbidities in patients with infected primary hip or knee arthroplasties","volume":"22","author":"Lai","year":"2007","journal-title":"J Arthroplasty."},{"issue":"5","key":"bib12-20230714","doi-asserted-by":"crossref","first-page":"1247","DOI":"10.1086\/514991","article-title":"Risk factors for prosthetic joint infection: case-control study","volume":"27","author":"Berbari","year":"1998","journal-title":"Clin Infect Dis."},{"issue":"3","key":"bib13-20230714","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/j.arth.2012.06.027","article-title":"In-hospital surgical site infections after primary hip and knee arthroplasty\u2014incidence and risk factors","volume":"28","author":"Poultsides","year":"2013","journal-title":"J Arthroplasty."},{"issue":"10","key":"bib14-20230714","doi-asserted-by":"crossref","first-page":"3112","DOI":"10.1007\/s11999-013-2923-9","article-title":"Medical comorbidities are independent preoperative risk factors for surgical infection after total joint arthroplasty","volume":"471","author":"Everhart","year":"2013","journal-title":"Clin Orthop Relat Res."},{"issue":"2","key":"bib15-20230714","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1111\/1469-0691.12209","article-title":"Risk factors for superficial wound complications in hip and knee arthroplasty","volume":"20","author":"Carroll","year":"2014","journal-title":"Clin Microbiol Infect."},{"issue":"12","key":"bib16-20230714","doi-asserted-by":"crossref","first-page":"1713","DOI":"10.1002\/art.24060","article-title":"Incidence and risk factors of prosthetic joint infection after total hip or knee replacement in patients with rheumatoid arthritis","volume":"59","author":"Bongartz","year":"2008","journal-title":"Arthritis Rheum."},{"issue":"3B","key":"bib17-20230714","doi-asserted-by":"crossref","first-page":"152S","DOI":"10.1016\/0002-9343(91)90361-Z","article-title":"Surgical wound infection rates by wound class, operative procedure, and patient risk index","volume":"91","author":"Culver","year":"1991","journal-title":"Am J Med."},{"issue":"5","key":"bib18-20230714","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1016\/j.arth.2011.09.013","article-title":"Diabetes mellitus, hemoglobin A1C, and the incidence of total joint arthroplasty infection","volume":"27","author":"Iorio","year":"2012","journal-title":"J Arthroplasty."},{"issue":"1","key":"bib19-20230714","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1007\/s11999-007-0016-3","article-title":"Obesity is a major risk factor for prosthetic infection after primary hip arthroplasty","volume":"466","author":"Dowsey","year":"2008","journal-title":"Clin Orthop Relat Res."},{"issue":"7","key":"bib20-20230714","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.arth.2005.04.023","article-title":"Obesity and perioperative morbidity in total hip and total knee arthroplasty patients","volume":"20","author":"Namba","year":"2005","journal-title":"J Arthroplasty."},{"issue":"4","key":"bib21-20230714","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/S0883-5403(06)80183-X","article-title":"Preoperative nutritional status of total joint patients. Relationship to postoperative wound complications","volume":"6","author":"Greene","year":"1991","journal-title":"J Arthroplasty."},{"issue":"10","key":"bib22-20230714","doi-asserted-by":"crossref","first-page":"606","DOI":"10.2307\/30148464","article-title":"CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections","volume":"13","author":"Horan","year":"1992","journal-title":"Infect Control Hosp Epidemiol."},{"issue":"2","key":"bib23-20230714","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/S0196-6553(99)70088-X","article-title":"Guideline for prevention of surgical site infection, 1999","volume":"27","author":"Mangram","year":"1999","journal-title":"Am J Infect Control."},{"issue":"11","key":"bib24-20230714","doi-asserted-by":"crossref","first-page":"2992","DOI":"10.1007\/s11999-011-2102-9","article-title":"New definition for periprosthetic joint infection: from the Workgroup of the Musculoskeletal Infection Society","volume":"469","author":"Parvizi","year":"2011","journal-title":"Clin Orthop Relat Res."},{"issue":"9","key":"bib25-20230714","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.1086\/597584","article-title":"Improved surveillance for surgical site infections after orthopedic implantation procedures: extending applications for automated data","volume":"48","author":"Bolon","year":"2009","journal-title":"Clin Infect Dis."},{"key":"bib26-20230714","first-page":"131","article-title":"Decolonization of drug-resistant organisms before total joint arthroplasty","volume":"59","author":"Parvizi","year":"2010","journal-title":"Instr Course Lect."},{"issue":"3","key":"bib27-20230714","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1016\/j.ejim.2010.02.006","article-title":"Preoperative hyperglycemia predicts infected total knee replacement","volume":"21","author":"J\u00e4msen","year":"2010","journal-title":"Eur J Intern Med."},{"issue":"6","key":"bib28-20230714","doi-asserted-by":"crossref","first-page":"1577","DOI":"10.1007\/s11999-008-0551-6","article-title":"Obese diabetic patients are at substantial risk for deep infection after primary TKA","volume":"467","author":"Dowsey","year":"2009","journal-title":"Clin Orthop Relat Res."},{"issue":"1","key":"bib29-20230714","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.otsr.2010.06.016","article-title":"Total knee replacement in post-traumatic arthritic knees with limitation of flexion","volume":"97","author":"Massin","year":"2011","journal-title":"Orthop Traumatol Surg Res."},{"issue":"5","key":"bib30-20230714","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1016\/j.arth.2008.04.004","article-title":"Total hip arthroplasty for posttraumatic arthritis after acetabular fracture","volume":"24","author":"Ranawat","year":"2009","journal-title":"J Arthroplasty."},{"issue":"8","key":"bib31-20230714","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1016\/j.injury.2007.12.004","article-title":"Total hip replacement for acetabular fractures. Results in 121 patients operated between 1983 and 2003","volume":"39","author":"Sermon","year":"2008","journal-title":"Injury."},{"issue":"3","key":"bib32-20230714","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1054\/arth.2003.50068","article-title":"Total knee arthroplasty in post-traumatic arthrosis of the knee","volume":"18","author":"Weiss","year":"2003","journal-title":"J Arthroplasty."},{"issue":"3","key":"bib33-20230714","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1089\/sur.2014.085","article-title":"Infected prostheses after lower-extremity bone tumor resection: clinical outcomes of 100 patients","volume":"16","author":"Mavrogenis","year":"2015","journal-title":"Surg Infect (Larchmt)."}],"container-title":["Journal of Bone and Joint Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/00004623-201609210-00003","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:31:08Z","timestamp":1787751068000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/00004623-201609210-00003"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,9,21]]},"references-count":32,"journal-issue":{"issue":"18","published-print":{"date-parts":[[2016]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.15.00988","relation":{},"ISSN":["0021-9355","1535-1386"],"issn-type":[{"value":"0021-9355","type":"print"},{"value":"1535-1386","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,9,21]]}}}