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Introduction: In the past 10 years a single surgeon has implanted 590 IPPs at our institution. In that same period, we have noted an infection rate of approximately 2% of new IPPs. A retrospective analysis was performed to examine potential patient health and socioeconomic factors that influence our IPP infection rate. Our investigation revealed that patients engaging in substance abuse at the time of implantation are more likely to have infection after IPP placement.
Materials & Methods: This is a retrospective single-institution IRB-exempt study of 590 patients who underwent IPP placement. Relevant elements of patients’ operative notes and charts were extensively reviewed to compile study data. Rigorous statistical analysis was performed.
Results: Between 2002 and 2014, 590 patients underwent IPP placement. Age, operative data, and rates of hypertension, hyperlipidemia, diabetes, HIV status, and MRSA infection were established. Also documented were HbA1c, preoperative blood glucose, CD4 count, active and historical substance abuse, former and current smoking, insurance status, employment status, homelessness, and ethnicity. Post-operative infection occurred in 12 patients. Of these, 5 (42%) were engaged in substance abuse at the time of infection. The rate of documented concurrent substance abuse in the 590 total implants was approximately 7.2%. No other patient socioeconomic or health factors approached statistical significance.
Conclusions: Active substance abuse at the time of implantation appears to be a newly-identified risk factor for IPP infection in our population of IPP patients over the past 10 years. Other health and socioeconomic factors were not relevant to IPP infection risk.