| アブストラクト | BACKGROUND: This study aimed to evaluate the association of the initial body weight-stratified cefazolin antimicrobial prophylaxis (AMP) dose and surgical-site infection (SSI) in major orthopedic implant surgery. METHODS: This nationwide, retrospective cohort study used data from the Diagnosis Procedure Combination database. We included patients (age >/=18 years) who underwent major orthopedic implant surgery between July 2010 and March 2022. Patients underwent surgery with an initial cefazolin dose of either 1 g (1 g cefazolin group) or 2 g (2 g cefazolin group). Primary outcome was in-hospital SSI. Restricted cubic spline functions were used to estimate the nonlinear association of body weight-stratified cefazolin dose with the outcome and between cefazolin dose per weight and the outcome. RESULTS: Among the 408,487 participants, 394,731 and 13,756 were in the 1 g and 2g cefazolin groups, respectively. The 1 g cefazolin group, but not the 2 g cefazolin group, showed a J-shaped relationship between body weight and SSI, which increased continuously beyond 50 kg, in an increased risk of SSI with body weight. A reverse J-shaped relationship was observed between cefazolin dose per weight and SSI, with an increased risk of SSI at <20 mg/kg. CONCLUSION: An increased risk of SSI was observed with 1 g cefazolin, but not with 2 g cefazolin, as an initial AMP with higher body weight among adults weighing >50 kg. |
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| ジャーナル名 | Annals of clinical epidemiology |
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| Pubmed追加日 | 2026/8/19 |
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| 投稿者 | Hatano, Masaki; Sasabuchi, Yusuke; Yamada, Koji; Aso, Shotaro; Ishikura, Hisatoshi; Tanaka, Takeyuki; Tanaka, Sakae; Yasunaga, Hideo |
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| 組織名 | Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, Tokyo, Japan.;Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo,;Tokyo, Japan.;Department of Real-world Evidence, Graduate School of Medicine, The University of;Tokyo, Tokyo, Japan.;Department of Orthopaedic Surgery, Nakanoshima Orthopaedics, Kanagawa, Japan.;Department of Health Services Research, Graduate School of Medicine, The;University of Tokyo, Tokyo, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/42614774/ |
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