Limited Evidence of Increased Associated SSI Risk
Limited strength evidence supports that patients meeting one or more of the following criteria are at an increased risk of infection after hip and knee arthroplasty:
• Cancer
• Hypertension (conflicting evidence)
• Liver Disease (conflicting evidence)

Rationale

Cancer
Two high quality studies showed a correlation between cancer and the risk of SSI. Many of the studies did not specify the type of cancer or the staging of the cancer, which is why this recommendation was downgraded to “limited”. Cancer encompasses a wide variety of disorders, tissues and severity.

Hypertension
Seven high quality studies were reviewed. Four of the studies showed no correlation between hypertension and risk of surgical site infection. The magnitude of the effect of hypertension on the risk of SSI could not be determined from the included studies.

Liver Disease
Five studies reviewed the correlation between unspecified liver disease, cirrhosis and SSI. Three of the studies showed a correlation between liver disease and SSI in larger multivariant studies.


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