FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W4225888857> ?p ?o ?g. }

• W4225888857 endingPage "1517" @default.
• W4225888857 startingPage "1515" @default.
• W4225888857 abstract "Where Are We Now? Longer length of stay (LOS) and unplanned hospital readmissions adversely affect patients’ experiences, can cause harm, and are expensive. In the past two decades, enhanced recovery pathways that focus on opioid-sparing multimodal analgesia, blood management, early mobilization, and discharge in ways that are believed not to adversely affect safety have become common practice after THA or TKA, and can improve patient care and reduce LOS after elective orthopaedic surgery [7, 12]. These pathways can be implemented without increasing complications, readmissions, morbidity, or mortality [12, 13] This allows for the delivery of high-quality patient care within more restricted healthcare budgets and may improve patient satisfaction, allowing patients to recover in their home environments and achieve independence as early as possible. Both surgery-related and patient-related factors are associated with surgical site infections. One important patient factor linked to surgical site infection in patients undergoing elective orthopaedic procedures and those treated for trauma is Staphylococcus aureus colonization [10, 15]. Because of this, screening and decolonization before surgery have emerged as a strategy to diminish staphylococcal infections [2, 5, 17]. Although various screening and decolonization strategies have been reported, we still lack a consensus about the most appropriate strategy [16]. In the current study, Santana et al. [14] found that S. aureus colonization was associated with problems that were unrelated to infection, specifically increased LOS after THA and 90-day readmission after TKA. This is probably because of unmeasured confounding factors. Patients who screen positive for S. aureus may have other underlying medical problems, which may have driven the findings in this report. However, based on these findings, surgeons should inform patients preoperatively that colonization is a risk factor for a longer LOS and readmission. Second, patients with colonization should be monitored more closely postoperatively because early intervention could avoid subsequent readmission. Where Do We Need To Go? The current study [14] is, to my knowledge, the first study to show a relationship between S. aureus colonization and increased LOS after THA and 90-day readmission after TKA, and so we need to determine whether these findings can be consistently replicated in other centers with other patient populations. As the authors point out, it is unlikely that there is a causal link between colonization and the short-term outcomes of arthroplasty, but colonization with S. aureus may serve as a proxy for patient factors that were not explored in the current study. Future studies might dig deeper to identify those factors and to see whether any of them are modifiable. Recent studies showed that a screening and decolonization regimen reduces nasal colonization with S. aureus prior to arthroplasty [4, 11], but others showed that colonization persists in 20% to 33% of patients, despite decolonization [1, 6]. Whether persistent colonization is a function of nonadherence to the decolonization protocol, the type of carrier (intermittent versus persistent) and level of carriage, or other patient risk factors is not known and needs further study. How Do We Get There? Large institutional databases would allow us to investigate the applicability of the findings of the current study in other centers. Such studies should determine the reasons for prolonged LOS and readmissions. Researchers could then compare them between patients with colonization and those without. Future research should also focus on the underlying patient factors that influence infection, longer LOS, and higher readmission rate after arthroplasty in patients with S. aureus colonization. Risk factors for colonization that are also associated with an increased short-term complication rate after arthroplasty include obesity, gender, age, residency, diabetes, renal insufficiency, and immunosuppression, but there still is disagreement on many of these points. Not all studies have found the same risk factors for colonization, so more data are needed to determine what the risk factors for colonization are exactly [3, 16]. Multiple regression analyses can help researchers determine which independent variables can be used to predict both S. aureus colonization and patient outcomes such as longer LOS and higher readmission rate. Studies need to determine whether the higher risk of complications in patients with colonization is true for all S. aureus carriers or whether some subclasses of carriers have a higher risk than others. The colonization rate in the general population varies worldwide, but three distinct patterns of nasal colonization have been identified in the general population: intermittent carriers (60%), persistent carriers (20%), and noncarriers (20%) [9]. In addition, a distinction can be made between low-level and high-level nasal carriage of S. aureus [8]. Studies looking at the relationship between colonization and infection or short-term complications after arthroplasty should consider these differences and evaluate whether intermittent versus persistent and/or low-level versus high-level carriage are risk factors for these outcomes. A combination of qualitative and quantitative culture results and repeat nasal culture swabs can help to predict S. aureus nasal carriage. We need to ascertain whether persistent colonization is more a function of patients’ nonadherence to recommended decolonization approaches, or whether persistent colonization occurs despite these approaches. Monitoring protocol adherence and screening to test for S. aureus control on the day of surgery would help to determine patient adherence to the protocol at the time of surgery and help to discriminate true persistent carriers versus non-adherence to the decolonization protocol. Linking outcome data to these subgroups could help determine whether colonization is a modifiable or nonmodifiable risk factor for some short-term outcomes after arthroplasty in these subgroups. It could also help to optimize decolonization strategies. If noninfectious complications and S. aureus colonization have underlying risk factors in common, studies should determine whether they are modifiable and can therefore reduce colonization and, most importantly, the complication rate." @default.
• W4225888857 created "2022-05-05" @default.
• W4225888857 creator A5083026664 @default.
• W4225888857 date "2022-03-08" @default.
• W4225888857 modified "2023-10-05" @default.
• W4225888857 title "CORR Insights®: Preoperative Colonization With Staphylococcus Aureus in THA is Associated With Increased Length of Stay" @default.
• W4225888857 cites W1708359513 @default.
• W4225888857 cites W1978612295 @default.
• W4225888857 cites W1995862591 @default.
• W4225888857 cites W2026273074 @default.
• W4225888857 cites W2039665478 @default.
• W4225888857 cites W2048444495 @default.
• W4225888857 cites W2096583086 @default.
• W4225888857 cites W2111113492 @default.
• W4225888857 cites W2113878566 @default.
• W4225888857 cites W2157715904 @default.
• W4225888857 cites W2779985632 @default.
• W4225888857 cites W3006110143 @default.
• W4225888857 cites W3091180359 @default.
• W4225888857 cites W4210641550 @default.
• W4225888857 doi "https://doi.org/10.1097/corr.0000000000002172" @default.
• W4225888857 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/35258499" @default.
• W4225888857 hasPublicationYear "2022" @default.
• W4225888857 type Work @default.
• W4225888857 citedByCount "0" @default.
• W4225888857 crossrefType "journal-article" @default.
• W4225888857 hasAuthorship W4225888857A5083026664 @default.
• W4225888857 hasBestOaLocation W42258888571 @default.
• W4225888857 hasConcept C141071460 @default.
• W4225888857 hasConcept C160735492 @default.
• W4225888857 hasConcept C162324750 @default.
• W4225888857 hasConcept C177713679 @default.
• W4225888857 hasConcept C2775944032 @default.
• W4225888857 hasConcept C2779489039 @default.
• W4225888857 hasConcept C50522688 @default.
• W4225888857 hasConcept C523546767 @default.
• W4225888857 hasConcept C54355233 @default.
• W4225888857 hasConcept C68312169 @default.
• W4225888857 hasConcept C71924100 @default.
• W4225888857 hasConcept C86803240 @default.
• W4225888857 hasConceptScore W4225888857C141071460 @default.
• W4225888857 hasConceptScore W4225888857C160735492 @default.
• W4225888857 hasConceptScore W4225888857C162324750 @default.
• W4225888857 hasConceptScore W4225888857C177713679 @default.
• W4225888857 hasConceptScore W4225888857C2775944032 @default.
• W4225888857 hasConceptScore W4225888857C2779489039 @default.
• W4225888857 hasConceptScore W4225888857C50522688 @default.
• W4225888857 hasConceptScore W4225888857C523546767 @default.
• W4225888857 hasConceptScore W4225888857C54355233 @default.
• W4225888857 hasConceptScore W4225888857C68312169 @default.
• W4225888857 hasConceptScore W4225888857C71924100 @default.
• W4225888857 hasConceptScore W4225888857C86803240 @default.
• W4225888857 hasIssue "8" @default.
• W4225888857 hasLocation W42258888571 @default.
• W4225888857 hasLocation W42258888572 @default.
• W4225888857 hasLocation W42258888573 @default.
• W4225888857 hasOpenAccess W4225888857 @default.
• W4225888857 hasPrimaryLocation W42258888571 @default.
• W4225888857 hasRelatedWork W1586374228 @default.
• W4225888857 hasRelatedWork W2003938723 @default.
• W4225888857 hasRelatedWork W2047967234 @default.
• W4225888857 hasRelatedWork W2118496982 @default.
• W4225888857 hasRelatedWork W214433981 @default.
• W4225888857 hasRelatedWork W2364998975 @default.
• W4225888857 hasRelatedWork W2369162477 @default.
• W4225888857 hasRelatedWork W2439875401 @default.
• W4225888857 hasRelatedWork W4238867864 @default.
• W4225888857 hasRelatedWork W2525756941 @default.
• W4225888857 hasVolume "480" @default.
• W4225888857 isParatext "false" @default.
• W4225888857 isRetracted "false" @default.
• W4225888857 workType "article" @default.