Introduction

In the background of the aging population, an increase of geriatric patients with specific age-related co-morbidities has already been seen over the years for proximal femur fractures in orthopaedic surgery as well as other medical disciplines. However, the geriatric aspect has not been well recognized in periprosthetic joint infection (PJI) patients so far. Therefore, this paper seeks to provide an overview on the co-morbidities of PJI patients with respect to the definition of geriatric patients.

Material and methods

In this single-center retrospective study, patients treated between 2007 and 2020 for PJI were included (n = 255). Patients were defined as geriatric according to the consensus definition criteria of the Federal Working Group of Clinical Geriatric Facilities e.V., the German Society for Geriatrics e.V. and the German Society for Gerontology and Geriatrics e.V. based on age (≤70 years), geriatric multimorbidity and the Barthel index (≤30).

Results

Applying the criteria defined 184 of the 255 (72.2%) PJI patients as geriatric infection patients. Regarding geriatric comorbidity, incontinence was most prevalent (38.1%), followed by immobility (25.6%). Comparing the geriatric infection patients with those classified as non-geriatric (n = 71) revealed that geriatric patients had a longer hospital stay and spent more days in the intensive care unit (ICU). Also, the amputation rate and the 5-year mortality rate was significantly increased (n = 15, 8.2% vs n = 1, 1.4%, P = .007 and n = 24, 13.0% vs n = 5, 7.0%, P = .005). The Barthel index showed a significant correlation with mortality (r = −.22, P = .011).

Discussion

We propose to use the term orthogeriatric infection patients in those cases in order to focus treatment not only on the orthopaedic infections but also on the important geriatric aspects.

Conclusion

The inclusion of geriatric physicians into the multidisciplinary team approach for PJI patients might be beneficial.

中文翻译：

---

假体周围感染“老年感染”一词的定义

介绍

在人口老龄化的背景下，多年来，在骨科手术和其他医学学科中，患有特定年龄相关合并症的老年患者因股骨近端骨折而增加。然而，迄今为止，假体周围关节感染（PJI）患者的老年问题尚未得到充分认识。因此，本文旨在根据老年患者的定义，概述 PJI 患者的合并症。

材料与方法

在这项单中心回顾性研究中，纳入了 2007 年至 2020 年间接受 PJI 治疗的患者 (n = 255)。根据联邦临床老年设施 eV 工作组、德国老年病学协会 eV 和德国老年学和老年病学协会 eV 的共识定义标准，根据年龄（≤70 岁）、老年多重病和巴塞尔指数（≤30）。

结果

应用该标准将 255 名 PJI 患者中的 184 名 (72.2%) 定义为老年感染患者。关于老年合并症，失禁最为普遍（38.1%），其次是不动（25.6%）。将老年感染患者与非老年感染患者 (n = 71 )进行比较后发现，老年患者住院时间更长，在重症监护室 (ICU) 的天数也更长。此外，截肢率和 5 年死亡率也显着增加（n = 15, 8.2% vs n = 1, 1.4%, P = .007和n = 24, 13.0% vs n = 5, 7.0%, P = .005)。Barthel 指数显示与死亡率显着相关（r = −.22，P = .011）。

讨论

我们建议在这些病例中使用术语“骨科感染患者”，以便不仅将治疗重点放在骨科感染上，还要重点关注重要的老年方面。

结论

将老年医生纳入针对 PJI 患者的多学科团队方法可能是有益的。