METHODS: We applied the JS-BACH classification to the Prosthetic Joint Infection in Australia and New Zealand Observational (PIANO) cohort. This prospective study of newly diagnosed PJI collected 2-year outcome data from 653 participants enrolled in 27 hospitals. The definition of PJI treatment failure at 24 months was any of the following: death, clinical or microbiological signs of infection, destination prosthesis removed, or ongoing antibiotic use. Individual cases were classified as per JS-BACH into \"1: uncomplicated\" (n = 268), \"2: complex\" (n = 330), and \"3: limited options\" (n = 55). This cohort was similar to the original JS-BACH population in terms of baseline characteristics. However, there was a difference in complexity, with more debridement, antibiotics, and implant retention procedures, fewer revision procedures, and a higher proportion of uncomplicated patients in the PIANO cohort.
RESULTS: The risk of treatment failure correlated strongly with the JS-BACH category, with odds ratios (95% confidence interval) for category 2 versus 1 of 1.75 (1.24 to 2.47) and for category 3 versus 1 of 7.12 (3.42 to 16.02).
CONCLUSIONS: Despite the PIANO study population being less complicated than the original derivation cohort, the JS-BACH classification showed a clear association with treatment failure in this large external cohort.
方法:我们将JS-BACH分类应用于澳大利亚和新西兰的假肢关节感染观察(PIANO)队列。这项新诊断的PJI的前瞻性研究收集了27家医院的653名参与者的2年结局数据。24个月时PJI治疗失败的定义是以下任何一种:死亡,临床或微生物感染的迹象,移除目的地假体,或持续使用抗生素。根据JS-BACH将个别病例分类为“1-不复杂”(n=268),“2-复杂”(n=330),和“3-有限选项”(n=55)。该队列在基线特征方面与原始JS-BACH群体相似。然而,复杂性有所不同,有更多的DAIR(清创术,抗生素,植入物保留)程序,更少的修订程序,在PIANO队列中,无并发症患者的比例更高。
结果:治疗失败的风险与JS-BACH类别密切相关,2类与1类的比值比(95%CI[置信区间])为1.75(1.24至2.47),3类与1类的比值比为7.12(3.42至16.02)。
结论:尽管PIANO研究人群没有原始推导队列复杂,在这一大型外部队列中,JS-BACH分类与治疗失败有明显关联.