Risk of septic arthritis after corticosteroid joint injections: A retrospective propensity score-matched cohort analysis.

IF 2.8 4区医学 Q1 REHABILITATION

PM&R Pub Date : 2025-07-03 DOI:10.1002/pmrj.13414

Claire Cooper, Reuben Horace, Richard Wilson

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引用次数: 0

Abstract

Background: Septic arthritis (SA) is a rare but serious complication of corticosteroid joint injections (CSI) that can lead to joint damage and possible mortality. There is limited research defining the true risk of SA following large joint corticosteroid injection.

Objective: To determine the absolute and risks difference of SA after large joint corticosteroid injection.

Design: A retrospective cohort study of electronic health records identified patients from a multicenter and nationwide database in the United States who had an ambulatory visit with a diagnosis of arthritis. The absolute risk of SA after a large joint corticosteroid injection was calculated, as was the risk difference based on presence or absence of large joint corticosteroid injection. To calculate the risk difference, patients were propensity-score matched (1:1) based on risk factors such as demographics, comorbidities, or nonhealth-related risk factors. The primary outcome was SA diagnosis between 1 and 21 days after the large joint corticosteroid injection. The risk of SA was compared between matched cohorts with 95% confidence intervals (CIs).

Results: The absolute risk for SA was found to be 0.0018, whereas the risk difference of SA after major joint corticosteroid injection was 0.0010 and the risk without major joint corticosteroid injection was 0.0017. The risk difference for those with a large joint corticosteroid injection compared to the control group was -0.0007 (95% CI, -0.0009 to -0.0005, p < .0001).

Conclusion: Current standard practices related to major joint corticosteroid injection do not increase the risk of SA.

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皮质类固醇关节注射后脓毒性关节炎的风险：回顾性倾向评分匹配队列分析。

背景：脓毒性关节炎（SA）是皮质类固醇关节注射（CSI）的一种罕见但严重的并发症，可导致关节损伤和可能的死亡。关于大剂量关节类固醇注射后SA的真正风险的研究有限。目的：探讨大关节皮质类固醇注射后SA的绝对发生率和危险程度的差异。设计：一项回顾性队列研究，从美国多中心和全国数据库中确定了诊断为关节炎的门诊患者的电子健康记录。计算大剂量关节皮质类固醇注射后SA的绝对风险，以及存在或不存在大剂量关节皮质类固醇注射的风险差异。为了计算风险差异，根据人口统计学、合并症或非健康相关风险因素等风险因素对患者进行倾向-评分匹配（1:1）。主要结果是大关节皮质类固醇注射后1至21天的SA诊断。以95%置信区间（ci）比较匹配队列之间SA的风险。结果：发现SA的绝对风险为0.0018，而大关节皮质类固醇注射后SA的风险差异为0.0010，未大关节皮质类固醇注射后SA的风险差异为0.0017。与对照组相比，大剂量关节皮质类固醇注射的风险差异为-0.0007 （95% CI, -0.0009至-0.0005,p）。结论：目前与大剂量关节皮质类固醇注射相关的标准做法不会增加SA的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

PM&R REHABILITATION-SPORT SCIENCES

CiteScore

4.30

自引率

4.80%

发文量

187

审稿时长

4-8 weeks

期刊介绍： Topics covered include acute and chronic musculoskeletal disorders and pain, neurologic conditions involving the central and peripheral nervous systems, rehabilitation of impairments associated with disabilities in adults and children, and neurophysiology and electrodiagnosis. PM&R emphasizes principles of injury, function, and rehabilitation, and is designed to be relevant to practitioners and researchers in a variety of medical and surgical specialties and rehabilitation disciplines including allied health.