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Analysis of Risk Factors for Infection in Orthopedic Trauma Patients
Journal of Trauma and Injury 2019;32(1):40-46
Published online March 30, 2019
© 2019 The Korean Society of Trauma.

Gi Ho Moon, Jae-Woo Cho, Beom Soo Kim, Do Hyun Yeo, Jong-Keon Oh

Department of Orthopedic Surgery, Guro Hospital, Korea University Medical Center, Seoul, Korea
Correspondence to: Jae-Woo Cho, M.D., Department of Orthopedic Surgery, Guro Hospital, Korea University Medical Center, 148 Gurodong-ro, Guro-gu, Seoul 08308, Korea, Tel: +82-2-2626-1178, Fax: +82-2-863-1684, E-mail: jeus1103@gmail.com
Received June 19, 2018; Revised October 16, 2018; Accepted October 18, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract

Purpose

We perform an analysis of infection risk factors for fracture patients and confirm that the risk factors reported in previous studies increase the risk of actual infection among fractured patients. In addition, injury severity score (ISS) which is used as an evaluation tool for morbidity of trauma patients, confirms whether there is a relationship with infection after orthopedic fracture surgery.

Methods

We retrospectively reviewed 1,818 patients who underwent fixation surgery at orthopedic trauma team, focused trauma center from January 1, 2015 to December 31, 2017. Thirty-five patients were infected after fracture surgery. We analyzed age, sex, open fracture criteria based on Gustilo-Aderson classification 3b, anatomical location (upper extremity or lower extremity) of fracture, diabetes, smoking, ISS.

Results

Of 1,818 patients, 35 (1.9%) were diagnosed with postoperative infection. Of the 35 infected patients, nine (25.7%) were female and five (14.0%) were upper extremity fractures. Three (8.6%) were diagnosed with diabetes and eight (22.8%) were smokers. Thirteen (37.1%) had ISS less than nine points and six (17.1%) had ISS 15 points or more. Of 1,818 patients, 80 had open fractures. Surgical site infection were diagnosed in 12 (15.0%) of 80. And nine of 12 were checked with Gustilo-Aderson classification 3b or more. Linear logistic regression analysis was performed using statistical analysis program Stata 15 (Stata Corporation, College Station, TX, USA). In addition, independent variables were logistic regression analyzed individually after Propensity scores matching. In all statistical analyzes, only open fracture was identified as a risk factor.

Conclusions

The risk factors for infection in fracture patients were found to be significantly influenced by open fracture rather than the underlying disease or anatomical feature of the patient. In the case of ISS, it is considered that there is a limitation. It is necessary to develop a new scoring system that can appropriately approach the morbidity of fracture trauma patients.

Keywords : Fracture, Infection, Risk factor, ISS


June 2019, 32 (2)
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