Incidence and Risk Factors of Infection After Fracture Fixation: A Multicenter Cohort Study
ABSTRACT Purpose Infection after fracture fixation (IAFF) is a severe complication. There are few multicenter studies targeting IAFF. This paper identifies independent risk factors associated with IAFF by analyzing multicenter clinical data. Appropriate interventions should be implemented to reduce...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2025-01-01
|
| Series: | Orthopaedic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/os.14278 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841527126108405760 |
|---|---|
| author | Baisheng Wang Jingdong Zhang Wenfeng Han Xin Tang Feng Tian |
| author_facet | Baisheng Wang Jingdong Zhang Wenfeng Han Xin Tang Feng Tian |
| author_sort | Baisheng Wang |
| collection | DOAJ |
| description | ABSTRACT Purpose Infection after fracture fixation (IAFF) is a severe complication. There are few multicenter studies targeting IAFF. This paper identifies independent risk factors associated with IAFF by analyzing multicenter clinical data. Appropriate interventions should be implemented to reduce the risk of IAFF. Methods This is a multicenter retrospective cohort study. This study screened medical records of patients who underwent internal fixation for fractures at participating medical institutions from January 1, 2011, to December 31, 2020. Data extraction included demographic characteristics, disease features, surgical variables, and laboratory indicators. Logistic regression analysis was employed to identify the relationship between relevant risk factors and IAFF. Research data were sourced from the hospital's electronic medical record system and self‐constructed databases. Results In our study, 202 patients who underwent internal fixation for fractures experienced postoperative infections, which corresponds to an overall incidence rate of approximately 1.7%. The predominant pathogen identified in these infections was Staphylococcus aureus. A multifactorial analysis indicated that several factors were independently associated with the occurrence of IAFF. These factors included BMI ranges of 24.0–27.9 and 28.0–31.9, smoking, a high ASA score, high‐energy trauma, diabetes, open fracture, seasonal timing of the surgery (summer), bone grafting, drainage duration, surgical duration ≥ 180 min, and A/G ratio < 1.2. Conclusions We strongly recommend that orthopedic surgeons perform comprehensive preoperative assessments on fracture patients to identify factors that may increase the risk of infection. Through the implementation of targeted interventions and beneficial modifications to these modifiable risk factors, it is possible to lower the incidence of IAFF. Additionally, proactive screening, risk stratification, and thorough patient education should be prioritized for patients with high risk but nonmodifiable factors. |
| format | Article |
| id | doaj-art-be7a7b77eb364758af820fd483ea5d33 |
| institution | Kabale University |
| issn | 1757-7853 1757-7861 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Orthopaedic Surgery |
| spelling | doaj-art-be7a7b77eb364758af820fd483ea5d332025-01-16T05:31:15ZengWileyOrthopaedic Surgery1757-78531757-78612025-01-0117115116210.1111/os.14278Incidence and Risk Factors of Infection After Fracture Fixation: A Multicenter Cohort StudyBaisheng Wang0Jingdong Zhang1Wenfeng Han2Xin Tang3Feng Tian4Department of Orthopedics Shengjing Hospital of China Medical University Shenyang ChinaDepartment of Orthopedics Northeast International Hospital Shenyang ChinaDepartment of Orthopedics The General Hospital of Northern Theater Command Shenyang ChinaDepartment of Orthopedics First Affiliated Hospital of Dalian Medical University Dalian ChinaDepartment of Orthopedics Shengjing Hospital of China Medical University Shenyang ChinaABSTRACT Purpose Infection after fracture fixation (IAFF) is a severe complication. There are few multicenter studies targeting IAFF. This paper identifies independent risk factors associated with IAFF by analyzing multicenter clinical data. Appropriate interventions should be implemented to reduce the risk of IAFF. Methods This is a multicenter retrospective cohort study. This study screened medical records of patients who underwent internal fixation for fractures at participating medical institutions from January 1, 2011, to December 31, 2020. Data extraction included demographic characteristics, disease features, surgical variables, and laboratory indicators. Logistic regression analysis was employed to identify the relationship between relevant risk factors and IAFF. Research data were sourced from the hospital's electronic medical record system and self‐constructed databases. Results In our study, 202 patients who underwent internal fixation for fractures experienced postoperative infections, which corresponds to an overall incidence rate of approximately 1.7%. The predominant pathogen identified in these infections was Staphylococcus aureus. A multifactorial analysis indicated that several factors were independently associated with the occurrence of IAFF. These factors included BMI ranges of 24.0–27.9 and 28.0–31.9, smoking, a high ASA score, high‐energy trauma, diabetes, open fracture, seasonal timing of the surgery (summer), bone grafting, drainage duration, surgical duration ≥ 180 min, and A/G ratio < 1.2. Conclusions We strongly recommend that orthopedic surgeons perform comprehensive preoperative assessments on fracture patients to identify factors that may increase the risk of infection. Through the implementation of targeted interventions and beneficial modifications to these modifiable risk factors, it is possible to lower the incidence of IAFF. Additionally, proactive screening, risk stratification, and thorough patient education should be prioritized for patients with high risk but nonmodifiable factors.https://doi.org/10.1111/os.14278fracture fixationinfectionosteomyelitisregression analysisrisk factor |
| spellingShingle | Baisheng Wang Jingdong Zhang Wenfeng Han Xin Tang Feng Tian Incidence and Risk Factors of Infection After Fracture Fixation: A Multicenter Cohort Study Orthopaedic Surgery fracture fixation infection osteomyelitis regression analysis risk factor |
| title | Incidence and Risk Factors of Infection After Fracture Fixation: A Multicenter Cohort Study |
| title_full | Incidence and Risk Factors of Infection After Fracture Fixation: A Multicenter Cohort Study |
| title_fullStr | Incidence and Risk Factors of Infection After Fracture Fixation: A Multicenter Cohort Study |
| title_full_unstemmed | Incidence and Risk Factors of Infection After Fracture Fixation: A Multicenter Cohort Study |
| title_short | Incidence and Risk Factors of Infection After Fracture Fixation: A Multicenter Cohort Study |
| title_sort | incidence and risk factors of infection after fracture fixation a multicenter cohort study |
| topic | fracture fixation infection osteomyelitis regression analysis risk factor |
| url | https://doi.org/10.1111/os.14278 |
| work_keys_str_mv | AT baishengwang incidenceandriskfactorsofinfectionafterfracturefixationamulticentercohortstudy AT jingdongzhang incidenceandriskfactorsofinfectionafterfracturefixationamulticentercohortstudy AT wenfenghan incidenceandriskfactorsofinfectionafterfracturefixationamulticentercohortstudy AT xintang incidenceandriskfactorsofinfectionafterfracturefixationamulticentercohortstudy AT fengtian incidenceandriskfactorsofinfectionafterfracturefixationamulticentercohortstudy |