BACKGROUND: @entity281 ( @entity281 ) is one of the most challenging and costly complications associated with @entity2720 . Our primary aim in this case-controlled trial was to compare the risk of @entity281 within a year of surgery for @entity1 undergoing primary total knee arthroplasty (TKA) or total hip arthroplasty (THA) and revision TKA or THA under general anesthesia versus neuraxial anesthesia. Our secondary aim was to determine which @entity1 , anesthetic, and surgical variables influence the risk of @entity281 . We hypothesized that @entity1 who undergo neuraxial anesthesia may have a lesser risk of @entity281 compared with those who had a general anesthetic. METHODS: We conducted a retrospective, case-control study of @entity1 undergoing primary or revision TKA and THA between January 1, 1998, and December 31, 2008, who subsequently were diagnosed with an @entity281 . The cases were matched 1:2 with controls based on type of joint replacement (TKA versus THA), type of procedure (primary, bilateral, revision), sex, date of surgery (within 1 year), ASA physical status (I and II versus III, IV, and V), and operative time (<3 vs >3 hours). RESULTS: During the 11-year period, 202 SSIs were identified. Of the infections identified, 115 (57%) occurred within the first 30 days and 87 (43%) occurred between 31 and 365 days. From both univariate and multivariable analyses, no significant association was found between the use of central neuraxial anesthesia and the @entity86 (univariate odds ratio [OR] = 0.92; 95% confidence interval [CI], 0.63-1.34; P = 0.651; multivariable OR = 1.10; 95% CI, 0.72-1.69; P = 0.664). The use of peripheral nerve block also was not found to influence the risk of @entity86 (univariate OR = 1.41; 95% CI, 0.84-2.37; P = 0.193; multivariable OR = 1.35; 95% CI, 0.75-2.44; P = 0.312). The factors that were found to be associated with @entity86 in multivariable analysis included current smoking (OR = 5.10; 95% CI, 2.30-11.33) and higher body mass index (BMI) (OR = 2.68; 95% CI, 1.42-5.06 for BMI >=  35 kg/m compared with those with BMI < 25 kg/m). CONCLUSIONS: Recent studies using large databases have concluded that the use of neuraxial compared with general anesthesia is associated with a decreased incidence of @entity281 in @entity1 undergoing @entity2720 . In this retrospective, case-controlled study, we found no difference in the incidence of @entity281 in @entity1 undergoing @entity2720 under general versus neuraxial anesthesia. We also concluded that the use of peripheral nerve blocks does not influence the incidence of @entity281 . Increasing BMI and current smoking were found to significantly increase the incidence of @entity281 in @entity1 undergoing lower extremity @entity2720 .

The Impact of Anesthetic Management on Surgical Site Infections in XXXX Undergoing Total Knee or Total Hip Arthroplasty.

@entity2720 :: ('MESH:D007592', 'Disease') :: ['total joint arthroplasty'] @entity281 :: ('MESH:D007239', 'Disease') :: ['Surgical site infection', 'SSI'] @entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity86 :: ('MESH:D019106', 'Disease') :: ['postoperative infection']
@entity1 :: (9606,Species) :: ['Patients']
