Journal article
Predictors of deep infection after distal femur fracture: a multicenter study
Journal of orthopaedic trauma, Vol.37(4), pp.161-167
04/2023
DOI: 10.1097/BOT.0000000000002514
PMID: 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.
Details
- Title: Subtitle
- Predictors of deep infection after distal femur fracture: a multicenter study
- Creators
- Dane Brodke - University of California, Los AngelesNathan O'Hara - R Adams Cowley Shock Trauma Center at the University of MarylandSai Devana - University of California, Los AngelesAdolfo Hernandez - University of California, Los AngelesCynthia Burke - University of Maryland, BaltimoreJayesh Gupta - University of Maryland, BaltimoreNatasha McKibben - University of Maryland, BaltimoreRobert O'Toole - R Adams Cowley Shock Trauma Center at the University of MarylandJohn Morellato - University of MississippiHunter Gillon - University of MississippiMurphy Walters - University of MississippiColby Barber - Virginia Commonwealth UniversityPaul Perdue - Virginia Commonwealth UniversityGraham Dekeyser - University of UtahLillia Steffenson - University of UtahLucas Marchand - University of UtahMarshall James Fairres - Harbor–UCLA Medical CenterLoren Black - Oregon Health & Science UniversityZachary Working - Oregon Health & Science UniversityErika Roddy - University of California, San FranciscoAshraf El Naga - University of California, San FranciscoMatthew Hogue - University of IowaTrevor Gulbrandsen - University of IowaOmar Atassi - Baylor College of MedicineThomas Mitchell - Baylor College of MedicineStephen Shymon - Harbor–UCLA Medical CenterChristopher Lee - University of California, Los Angeles
- Resource Type
- Journal article
- Publication Details
- Journal of orthopaedic trauma, Vol.37(4), pp.161-167
- Publisher
- Lippincott Williams & Wilkins
- DOI
- 10.1097/BOT.0000000000002514
- PMID
- 36302354
- ISSN
- 0890-5339
- eISSN
- 1531-2291
- Language
- English
- Date published
- 04/2023
- Academic Unit
- Orthopedics and Rehabilitation
- Record Identifier
- 9984747077902771
Metrics
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