Fatores que influenciam na infecção pós operatória em artroplastias
DOI:
https://doi.org/10.63162/v67n70e26694Palavras-chave:
Infecção, Periprotética, Artroplastia total, Fatores de risco, Infecção do sítio cirúrgicoResumo
Introdução: A infecção periprotética (IP) é uma das complicações mais graves da artroplastia total, com impacto significativo na morbidade, mortalidade e custos de saúde. Objetivo: Sintetizar a evidência disponível sobre os fatores que influenciam o desenvolvimento de infecções pós-cirúrgicas em artroplastia, fornecendo recomendações baseadas em evidências para prática clínica. Métodos: Foi realizada busca sistemática nas bases de dados PubMed, Web of Science e Scopus de estudos publicados entre 2006 e 2023 sobre infecção periprotética em artroplastia total. Foram incluídos estudos observacionais, ensaios clínicos e meta-análises que avaliassem fatores de risco para infecção periprotética em artroplastia total do quadril (ATQ) e joelho (ATJ). Resultados: Foram incluídos 9 estudos com um total de aproximadamente 1.200.000 pacientes. Os fatores de risco identificados foram classificados em: (1) fatores relacionados ao paciente (comorbidades, estado nutricional, tabagismo); (2) fatores cirúrgicos (duração da cirurgia, tipo de procedimento); (3) fatores hospitalares e socioeconômicos. Os fatores de risco mais consistentemente associados à infecção periprotética foram: diabetes mellitus (OR = 3,72), obesidade (OR = 2,53-4,00), doença reumatológica (RR = 1,71), tabagismo (RR = 2,37), duração cirúrgica prolongada e insuficiência cardíaca congestiva. Conclusão: Múltiplos fatores influenciam o desenvolvimento de infecções pós-cirúrgicas em artroplastia total. A identificação e otimização desses fatores de risco modificáveis é essencial para reduzir a incidência de infecção periprotética e melhorar os resultados clínicos.
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