Analysis of the direct economic burden of informational targeted monitoring results and periprosthetic joint infection in 1 629 cases of the knee arthroplasty

OBJECTIVE To explore the occurrence, effective monitoring methods and direct economic burden of surgical site infection（SSI） in knee arthroplasty, so as to provide a theoretical basis for formulating SSI monitoring and preventive measures in knee arthroplasty. METHODS From Jan 2018 to Dec 2019, patients who underwent knee arthroplasty for the first time were subject to SSI targeted monitoring. One year after surgery, they were followed up by telephone. The monitoring data were analyzed to obtain the condition of SSI after knee arthroplasty and evaluate the effectiveness of informational targeted monitoring. At the same time, the direct economic burden of treating periprosthetic joint infection（PJI） was analyzed the no infection group was screened out after 1∶2 propensity score matching. RESULTS In 1629 knee arthroplasty patients successfully followed up by telephone, 27 patients developed SSI within one year after operation, with the incidence of SSI of 1.66%. 14 cases had PJI（51.85%）, 8 cases had superficial incision infection（29.63%）, and 5 cases had deep incision infection（18.52%）. Within 30 days after operation, 16 cases occurred SSI（accounting for 59.26% of the total SSI）, and there were 25 cases of SSI within 90 days after operation（accounting for 92.59% of the total SSI）. A total of 21 cases of SSI were monitored by informational method（1.29%）. The total effective rate of SSI monitoring was 77.78%, and the effective rate of PJI monitoring was 100.00%. Compared with the uninfected group, the increased hospitalization days in the PJI group were 43.98 days and increased total expenses were 122 230.18 yuan（P＜0.001）, including significant increase of the cost of materials, medicine, examination and inspection, surgery, nursing and other expenses（P＜0.05）. CONCLUSION Informational targeted monitoring can effectively monitor SSI in the patients undergoing knee arthroplasty. SSI within 90 days after operation is the focus of monitoring. PJI has a heavy direct economic burden, which should be paid great attention to the prevention of SSI infection in knee arthroplasty.