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Septic hip revision was more expensive, linked with longer stay vs. aseptic revision

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Septic hip revision was more expensive, linked with longer stay vs. aseptic revision


August 08, 2022

1 min read


Source/Disclosures

Source:

Villa JM, et al. Paper 987. Presented at: Musculoskeletal Infection Society Annual Meeting; Aug. 5-6, 2022; Pittsburgh (hybrid meeting).


Disclosures:
Higuera-Rueda reports no relevant financial disclosures.


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Results showed septic hip revision was more expensive and had a longer length of stay compared with aseptic revision. Single-stage reimplantation presented the best value for society for periprosthetic joint infection treatment.

“We definitely need adjustments in reimbursement on the coding and hopefully that will reflect the reimbursement,” Carlos A. Higuera-Rueda, MD, said in his presentation at the Musculoskeletal Infection Society Annual Meeting.



Hip infection

Source: Adobe Stock

Higuera-Rueda and colleagues retrospectively categorized 473 patients who underwent approximately 600 unilateral total hip revisions based on whether they received an aseptic revision, irrigation and debridement for periprosthetic joint infection with insert exchange; explantation with or without a spacer; spacer-exchange, second-stage reimplantation or single-stage reimplantation. Researchers collected professional and technical charges and compared the total charges between patients who underwent aseptic revision with those who underwent septic revision.

“We had about 232 septic procedures vs. 364 aseptic procedures,” Higuera-Rueda said. “When we compared both groups, the only difference that we found in terms of demographics was BMI was slightly higher in the septic group in addition to having more males. But in terms of comorbidities, they were the same.”

Higuera-Rueda noted patients who underwent aseptic revision had a significantly shorter length of stay compared with the septic revision group.

“That is particularly true when we do explantation with and without a spacer, and spacer-exchange is the highest,” Higuera-Rueda said.

Patients who underwent septic revision had a significant increase in the percent of charges incurred, especially among patients who underwent explantation and spacer-exchange, according to Higuera-Rueda.

“Overall, when we looked at all types [of septic revision], the length of stay has a significant difference, almost twice for septic revisions, and when we look at the total hospital charges, it was almost 43% higher,” Higuera-Rueda said.