[Prosthetic infections and the increasing importance of psychological comorbidities : An epidemiological analysis for Germany from 2009 through 2019].

Abstract

Background: Periprosthetic joint infection (PJI) is a devastating complication in orthopedics and trauma surgery. A potential increase in PJI diagnoses, especially in combination with psychological comorbidities may become a significant challenge for healthcare stakeholders. So far, the prevalence for Germany is unknown, which makes it difficult to estimate future treatment demand or to predict developments that can be influenced by adapting prevention and treatment measures.

Objectives: The present study provides a detailed overview of the epidemiology of periprosthetic joint infections and psychological comorbidities.

Materials and methods: A dataset provided by the Federal Statistical Office (Destatis) consisting of annual, Germany-wide ICD-10 diagnosis codes from 2009 through 2019 was analyzed. Incidences of the code "T84.5-Infection and inflammatory reaction due to joint arthroplasty" were quantified, and a detailed breakdown of this data by age group and gender was performed. Prevalence rates of secondary diagnoses of the ICD-10 chapter F were determined.

Results: PJI diagnoses have been steadily increasing since 2009. The incidence declined in 2018. In 2019, 16,174 cases were registered, corresponding to a prevalence of 23.8/100,000 population. A trend towards more diagnoses in elderly patients became evident. Twenty-five percent of all patients had a secondary diagnosis regarding mental and behavioural disorders. The number of patients with psychological comorbidities doubled in the last decade.

Conclusions: Guidelines on prevention strategies as well as psychological support services should be implemented in trauma surgery.