Relationship between antibiotic use and mortality in critical care patients undergoing hip and knee arthroplasty: A propensity score matching analysis

This study aimed to investigate the relationship between antibiotic use and mortality in critical care patients undergoing hip and knee replacement surgeries. Patient data from the MIMIC-IV database were analyzed, with 1039 patients receiving antibiotics and 514 not receiving antibiotics. After propensity score matching, each group comprised 382 patients with similar baseline characteristics. Antibiotic use did not significantly reduce the 90-day mortality rate (RR = 1.25, 95% CI = 0.83-1.89), 30-day mortality rate (RR = 1.10, 95% CI = 0.96-1.51), or in-hospital mortality rate (RR = 1.11, 95% CI = 0.66-1.86) compared to the untreated group. It also did not affect the length of hospital stay (mean 6.53 days vs 5.92 days, P = .10) or ICU stay (mean 1.69 days vs 1.64 days, P = .19). Survival analysis showed no statistically significant differences between the groups. Binary logistic regression analysis identified body weight (OR = 0.98, 95% CI = 0.97-0.99, P < .01), SAPS II score (OR = 1.05, 95% CI = 1.04-1.07, P < .01), and Charlson Comorbidity Index (OR = 1.14, 95% CI = 1.03-1.26, P = .01) as independent risk factors for 90-day mortality. In conclusion, among patients who underwent hip and knee replacement surgeries and were admitted to the ICU, antibiotic use did not affect mortality rates or length of stay.