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 |
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Erscheinungsjahr: |
2011 |
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Erschienen: |
2011 |
Enthalten in: |
Zur Gesamtaufnahme - volume:469 |
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Enthalten in: |
Clinical orthopaedics and related research - 469(2011), 9 vom: 21. Sept., Seite 2621-30 |
Sprache: |
Englisch |
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Beteiligte Personen: |
Bachoura, Abdo [VerfasserIn] |
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Date Completed 30.09.2011 Date Revised 20.10.2021 published: Print-Electronic Citation Status MEDLINE |
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doi: |
10.1007/s11999-010-1737-2 |
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funding: |
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Förderinstitution / Projekttitel: |
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PPN (Katalog-ID): |
NLM204386675 |
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520 | |a 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 | ||
520 | |a QUESTIONS/PURPOSE: We determined the incidence and quantified modifiable and nonmodifiable risk factors for SSIs in patients with orthopaedic trauma undergoing surgery | ||
520 | |a 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 | ||
520 | |a 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) | ||
520 | |a 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) | ||
520 | |a LEVEL OF EVIDENCE: Level II, prognostic study. See the Guideline for Authors for a complete description of levels of evidence | ||
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700 | 1 | |a Zurakowski, David |e verfasserin |4 aut | |
700 | 1 | |a Ring, David |e verfasserin |4 aut | |
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