Is Arthroplasty Immediately After an Infected Case a Risk Factor for Infection?
Bibliographic record
Abstract
BACKGROUND: It is common practice in many centers to avoid performing a clean case in a room in which an infected procedure has just taken place. No studies of which we are aware speak to the necessity of this precaution. QUESTIONS/PURPOSES: The purposes of this study were to identify (1) the risk of infection in a group of patients who underwent arthroplasties performed immediately after a first-stage arthroplasty for joint infection; and (2) the risk of superficial and deep infections in these patients compared with a matched group of patients who underwent arthroplasties not performed after an infected surgery. METHODS: Eighty-three patients (85 arthroplasties) who underwent arthroplasties (primary or revision) immediately after patients with known infections underwent surgery in the same operating room (OR) were analyzed for 12 months after surgery to determine the incidence of infection. They were matched for demographic factors and surgery type with a control group of 321 patients (354 arthroplasties) who underwent surgery in an OR that had not just been used for surgery involving patients with infections. We compared the risk of superficial and deep infections between the groups. RESULTS: Patients in the study group were not more likely to have infections develop than those in the control group. One patient in the study group (1.17%) and three in the control group (0.84%) had deep infections develop; the infection in the patient in the study group was caused by a different organism than that of the patient with an infection whose surgery preceded in the OR. Two superficial infections (2.35%) were detected in the study group and 17 (4.8%) were detected in the control group. CONCLUSIONS: With the numbers available, we found that a deep infection was not more likely to occur in a patient without an infection after an arthroplasty that followed surgery on a patient with an infection than in one who had surgery after a clean case. Although sample size was a potential issue in this study, the results may serve as hypothesis generating for future studies. LEVEL OF EVIDENCE: Level III, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".