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

Published on May 4, 2021in Modern Rheumatology2.113
· DOI :10.1080/14397595.2020.1790138
Shunji Okita (Okayama University), Hajime Ishikawa12
Estimated H-index: 12
+ 5 AuthorsToshifumi Ozaki57
Estimated H-index: 57
(Okayama University)
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 (BMI), 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 pre-operative use of tocilizumab were significant in the univariate analyses. These variables were entered into a multivariate model, and it was revealed that pre-operative 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 pre-operative use of tocilizumab and procedures in the foot and ankle were risk factors for DWH.
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