Risk factors of postoperative delayed wound healing in patients with rheumatoid arthritis treated with a biological agent.

Abstract

OBJECTIVES:

This retrospective study aimed to investigate the risk factors associated with delayed wound healing (DWH) after orthopedic surgery in rheumatoid arthritis (RA) patients treated with biological disease-modifying antirheumatic drugs (bDMARDs).

METHODS:

We reviewed medical records of 276 orthopedic procedures for 187 RA patients treated with bDMARDs. As a preoperative nutritional status assessment, we evaluated body mass index, prognostic nutritional index (PNI), and controlling nutritional status (CONUT). We evaluated DAS28-CRP, DAS28-ESR, face scale, global health, and HAQ-DI to assess the disease activity. Univariate and multivariate logistic regression analyses were performed to evaluate the risk factors for DWH.

RESULTS:

In 276 procedures, DWH was identified in 24 patients (8.7%). Disease duration, foot and ankle surgery, and preoperative use of tocilizumab were significant in the univariate analyses. These variables were entered into a multivariate model, and it was revealed that preoperative use of tocilizumab and procedures in the foot and ankle were associated with an increased risk of DWH.

CONCLUSION:

The current retrospective study suggested that preoperative use of tocilizumab and procedures in the foot and ankle were risk factors for DWH.

• Authors: Shunji Okita, Hajime Ishikawa, Asami Abe, Satoshi Ito, Kiyoshi Nakazono, Akira Murasawa, Keiichiro Nishida, Toshifumi Ozaki
• Journal: Modern rheumatology (Mod Rheumatol) Vol. 31 Issue 3 Pg. 587-592 (May 2021) ISSN: 1439-7609 [Electronic] England
• PMID: 32613884 (Publication Type: Journal Article)

Chemical References

• Antibodies, Monoclonal, Humanized
• Antirheumatic Agents
• Biological Factors
• tocilizumab

Topics

• Antibodies, Monoclonal, Humanized (administration & dosage, adverse effects, therapeutic use)
• Antirheumatic Agents (administration & dosage, adverse effects, therapeutic use)
• Arthritis, Rheumatoid (drug therapy, surgery)
• Biological Factors (administration & dosage, adverse effects, therapeutic use)
• Female
• Humans
• Male
• Middle Aged
• Nutritional Status
• Orthopedic Procedures (adverse effects)
• Postoperative Complications (epidemiology)
• Retrospective Studies
• Risk Factors
• Wound Healing