Greater costs, longer LOS and higher inpatient mortality: 7 things to know about C diff. infection after revision TKA

Orthopedic

Although Clostridium difficile infection is rare after revision total knee arthroplasty, it is associated with longer length of stay, greater costs and higher in-hospital mortality, according to a study in European Journal of Orthopaedic Surgery & Traumatology.

Here are seven things to know:

1. Researchers queried the National Inpatient Sample database for patients diagnosed with periprosthetic joint infection and underwent revision TKA between 2009 and 2013. They identified 799 patients who developed C diff.during their inpatient stay.

2. After revision TKA secondary to periprosthetic joint infection, the incidence of C diff.was 1 percent. Patients who developed C diff.were older than patients who did not, with an average age of 69.05 years compared to 65.52 years.

3. C diff.patients had a median hospital LOS of 11 days compared to five days for patients who did not develop C diff.

4. Greater costs were associated with C diff.at $30,612.93 compared to $18,873.75 for uninfected patients. 

5. Only 0.5 percent of revision TKA patients without C diff. experienced in-hospital mortality compared to 3.6 percent of C diff.patients. 

6. Patients with C diff.were more likely to be treated in urban, nonprofit, medium-to-large hospitals in the Northeast and Midwest. They were more likely to have underlying depression or fluid/electrolyte disorders. 

7. "With increased legislative pressure to lower healthcare expenditures, it is crucial to identify means of preventing costly complications," study authors conclude.

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