Predictors of Deep Infection After Distal Femur Fracture: A Multicenter Study.
J Orthop Trauma
; 37(4): 161-167, 2023 04 01.
Article
em En
| MEDLINE
| ID: mdl-36302354
ABSTRACT
OBJECTIVES:
To identify potentially modifiable risk factors for deep surgical site infection after distal femur fracture.DESIGN:
Multicenter retrospective cohort study.SETTING:
Ten Level-I trauma centers. PATIENTS/PARTICIPANTS:
Patients with OTA/AO 33A or C distal femur fractures (n = 1107). INTERVENTION Surgical fixation of distal femur fracture. MAIN OUTCOME MEASUREMENT The outcome of interest was deep surgical site infection.RESULTS:
There was a 7% rate (79/1107) of deep surgical site infection. In the multivariate analysis, predictive factors included alcohol abuse [odds ratio (OR) = 2.36; 95% confidence interval (CI), 1.17-4.46; P = 0.01], intra-articular injury (OR = 1.73; 95% CI, 1.01-3.00; P = 0.05), vascular injury (OR = 3.90; 95% CI, 1.63-8.61; P < 0.01), the use of topical antibiotics (OR = 0.50; 95% CI, 0.25-0.92; P = 0.03), and the duration of the surgery (OR = 1.15 per hour; 95% CI, 1.01-1.30; P = 0.04). There was a nonsignificant trend toward an association between infection and type III open fracture (OR = 1.73; 95% CI, 0.94-3.13; P = 0.07) and lateral approach (OR = 1.60; 95% CI, 0.95-2.69; P = 0.07). The most frequently cultured organisms were methicillin-resistant Staphylococcus aureus (22%), methicillin-sensitive Staphylococcus aureus (20%), and Enterobacter cloacae (11%).CONCLUSIONS:
Seven percent of distal femur fractures developed deep surgical site infections. Alcohol abuse, intra-articular fracture, vascular injury, and increased surgical duration were risk factors, while the use of topical antibiotics was protective. LEVEL OF EVIDENCE Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Alcoolismo
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Staphylococcus aureus Resistente à Meticilina
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Lesões do Sistema Vascular
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Fraturas Expostas
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Fraturas Femorais Distais
Tipo de estudo:
Clinical_trials
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
J Orthop Trauma
Assunto da revista:
ORTOPEDIA
/
TRAUMATOLOGIA
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Canadá
País de publicação:
EEUU
/
ESTADOS UNIDOS
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ESTADOS UNIDOS DA AMERICA
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EUA
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UNITED STATES
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UNITED STATES OF AMERICA
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US
/
USA