Hyperhidrosis increases the risk of postoperative infections after shoulder arthroplasty and rotator cuff repair

Abstract

Background

Hyperhidrosis (HH), or excessive sweating, has been associated with higher rates of infections. Despite being a relatively common condition, its impact on postoperative outcomes following orthopedic procedures in proximity to the axilla, such as rotator cuff repair (RCR) and shoulder arthroplasty (SA), remains unknown.

Methods

A retrospective cohort study was conducted using the TriNetX globally federated database. Patients with and without HH who underwent either RCR or SA were matched based on patient demographics and comorbidities. A standard difference of <0.1 was used to assess success of propensity score matching. Primary outcomes were 90-day postoperative superficial soft tissue infections (SSTIs), deep infections, and wound complications. Tests of significance and risk ratios (RR) with 95% confidence intervals were calculated.

Results

After matching, 2,941 patients who underwent RCR and 2,066 patients who underwent SA were identified in each cohort. HH patients undergoing RCR demonstrated a higher risk of SSTIs (RR = 1.81; P = .007), urinary tract infection (UTI; RR = 2.09; P < .001), and emergency services usage (RR = 1.69; P < .001). Similarly, HH patients undergoing SA were also at higher risk of SSTIs (RR = 1.87; P = .004), UTI (RR = 1.65; P = .003), and emergency services usage (RR = 1.54; P < .001). There was no significant difference in the rates of deep soft tissue infections between the HH and non-HH groups for both RCR and SA.

Discussion

HH is associated with an increased risk for 90-day complications including SSTIs, UTIs, and emergency services usage following both RCR and SA. Additional strategies for optimizing surgical care of these patients should be investigated.