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Beom Soo Kim 1 Article
Analysis of Risk Factors for Infection in Orthopedic Trauma Patients
Gi Ho Moon, Jae-Woo Cho, Beom Soo Kim, Do Hyun Yeo, Jong-Keon Oh
J Trauma Inj. 2019;32(1):40-46.   Published online March 31, 2019
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AbstractAbstract PDF

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.


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.


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.


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.



Citations to this article as recorded by  
  • Analysis of Risk Factors and Association of Cluster of Differentiation (CD) Markers With Conventional Markers in Delayed Fracture Related Infection for Closed Fracture
    Archana Raikwar, Ajai Singh, Vikas Verma , Abbas Ali Mehdi, Narendra Singh Kushwaha, Rashmi Kushwaha
    Cureus.2021;[Epub]     CrossRef
  • Feasibility of Early Definitive Internal Fixation of Pelvic Bone Fractures in Therapeutic Open Abdomen
    Kyunghak Choi, Kwang-Hwan Jung, Min Ae Keum, Sungjeep Kim, Jihoon T Kim, Kyu-Hyouck Kyoung
    Journal of Trauma and Injury.2020; 33(1): 18.     CrossRef
  • Characterization and Antibiofilm Activity of Mannitol–Chitosan-Blended Paste for Local Antibiotic Delivery System
    Leslie R. Pace, Zoe L. Harrison, Madison N. Brown, Warren O. Haggard, J. Amber Jennings
    Marine Drugs.2019; 17(9): 517.     CrossRef

J Trauma Inj : Journal of Trauma and Injury