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Key features of bone and joint infections following the implementation of reference centers in France.

Abstract：

OBJECTIVES:French reference centers for bone and joint infections (BJI) were implemented from 2009 onwards to improve the management of complex BJIs. This study compared BJI burden before and after the implementation of these reference centers. PATIENTS AND METHODS:BJI hospital stays were selected from the 2008 and 2013 national hospital discharge database using a validated algorithm, adding the new complex BJI code created in 2011. Epidemiology and economic burden were assessed. RESULTS:BJI prevalence increased in 2013 (70 vs. 54/100,000 in 2008). Characteristics of BJI remained similar between 2008 and 2013: septic arthritis (50%), increasing prevalence with age and sex, case fatality 5%, mean length of stay 17.5 days, rehospitalization 20%. However, device-associated BJIs increased (34 vs. 26%) as well as costs (€421 million vs. €259 in 2008). Similar device-associated BJI characteristics between 2008 and 2013 were: septic arthritis (70%), case fatality (3%), but with more hospitalizations in reference centers (34 vs. 30%) and a higher cost per stay. Among the 7% of coded complex BJIs, the mean length of stay was 22.2 days and mean cost was €11,960. CONCLUSIONS:BJI prevalence highly increased in France. Complex BJI prevalence assessment is complicated by the absence of clinical consensus and probable undercoding. A validation of clinical case definition of complex BJI is required.

journal_name

Med Mal Infect

journal_title

Medecine et maladies infectieuses

authors

Laurent E,Gras G,Druon J,Rosset P,Baron S,Le-Louarn A,Rusch E,Bernard L,Grammatico-Guillon L

doi

10.1016/j.medmal.2018.02.004

subject

Has Abstract

pub_date

2018-06-01 00:00:00

pages

256-262

issue

4

eissn

0399-077X

issn

1769-6690

pii

S0399-077X(17)30067-7

journal_volume

48

pub_type

杂志文章

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