Infirmity and injury complexity are risk factors for surgical-site infection after operative fracture care

BACKGROUND: Orthopaedic surgical-site infections prolong hospital stays, double rehospitalization rates, and increase healthcare costs. Additionally, patients with orthopaedic surgical-site infections (SSI) have substantially greater physical limitations and reductions in their health-related quality of life. However, the risk factors for SSI after operative fracture care are unclear.

QUESTIONS/PURPOSE: We determined the incidence and quantified modifiable and nonmodifiable risk factors for SSIs in patients with orthopaedic trauma undergoing surgery.

PATIENTS AND METHODS: We retrospectively indentified, from our prospective trauma database and billing records, 1611 patients who underwent 1783 trauma-related procedures between 2006 and 2008. Medical records were reviewed and demographics, surgery-specific data, and whether the patients had an SSI were recorded. We determined which if any variables predicted SSI.

RESULTS: Six factors independently predicted SSI: (1) the use of a drain, OR 2.3, 95% CI (1.3-3.8); (2) number of operations OR 3.4, 95% CI (2.0-6.0); (3) diabetes, OR 2.1, 95% CI (1.2-3.8); (4) congestive heart failure (CHF), OR 2.8, 95% CI (1.3-6.5); (5) site of injury tibial shaft/plateau, OR 2.3, 95% CI (1.3-4.2); and (6) site of injury, elbow, OR 2.2, 95% CI (1.1-4.7).

CONCLUSION: The risk factors for SSIs after skeletal trauma are most strongly determined by nonmodifiable factors: patient infirmity (diabetes and heart failure) and injury complexity (site of injury, number of operations, use of a drain).

LEVEL OF EVIDENCE: Level II, prognostic study. See the Guideline for Authors for a complete description of levels of evidence.

Medienart:

E-Artikel

Erscheinungsjahr:

2011

Erschienen:

2011

Enthalten in:

Zur Gesamtaufnahme - volume:469

Enthalten in:

Clinical orthopaedics and related research - 469(2011), 9 vom: 21. Sept., Seite 2621-30

Sprache:

Englisch

Beteiligte Personen:

Bachoura, Abdo [VerfasserIn]
Guitton, Thierry G [VerfasserIn]
Smith, R Malcolm [VerfasserIn]
Vrahas, Mark S [VerfasserIn]
Zurakowski, David [VerfasserIn]
Ring, David [VerfasserIn]

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Journal Article

Anmerkungen:

Date Completed 30.09.2011

Date Revised 20.10.2021

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1007/s11999-010-1737-2

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM204386675