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Master Thesis

Rôle de l’état nutritionnel protidique dans la prise en charge des infections sur prothèses de hanche : à propos d’une série rétrospective continue de 136 patients sur 6 ans

Abstract : Background: Hip prosthesis infection is a serious complication with significant mortality and morbidity. Treatment and recommendations are still debated. The objective of this study is to know the infectious recurrence rate after treatment in a reference center for these infections. We also wanted to determine the risk factors for these recurrences. Method: A retrospective study was conducted on all cases of first hip prosthesis infection at the Grenoble Alpes Hospital and University Center from January 2012 to December 2017. Patients were considered to be cured in the absence of 1-year infectious recurrence. Risk factors such as undernutrition, to not remove polyethylene (PE) part in DAIR group (debridement, antibiotics, irrigation and retention) and non-compliance with consensus recommendations were analyzed. Results: Over the 6-year period, 136 patients presented with hip prosthesis infection. Seventy-seven (57%) were women. The median age was 71 years old. Sixty-seven patients (46%) had a Charlson score> 6. Include 91 (67%) DAIR, 30 (22%) changing the prosthesis in one stage and 15 (11%) changing in two stage. The initial recurrence rate was 35% and then 19% after surgical revision. Severe undernutrition (weight loss> 10% in 1 month or> 15% in 6 months, BMI <18, albuminemia <30 g / l) was an independent risk factor for infectious recurrence (OR = 4.25, 95% CI) 1.53-11.78, p = 0.01). In DAIR group, the non-change of PE and "non-referral" treatment were associated, but without statistical signification, with recidivism. Conclusion: The failure rate of treatment of hip prosthesis infections remains high. Systematic management of undernutrition, compliance with recommendations and the systematic change of PE could reduce this rate.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02319317
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Submitted on : Thursday, October 17, 2019 - 6:42:12 PM
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Camille Tronc. Rôle de l’état nutritionnel protidique dans la prise en charge des infections sur prothèses de hanche : à propos d’une série rétrospective continue de 136 patients sur 6 ans. Médecine humaine et pathologie. 2019. ⟨dumas-02319317⟩

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