Hardware Removal Due to Infection after Open Reduction and Internal Fixation: Trends and Predictors
محل انتشار: مجله استخوان و جراحی عمومی، دوره: 3، شماره: 3
سال انتشار: 1394
نوع سند: مقاله ژورنالی
زبان: انگلیسی
مشاهده: 190
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شناسه ملی سند علمی:
JR_TABO-3-3_007
تاریخ نمایه سازی: 11 بهمن 1400
چکیده مقاله:
Background: Little is known about trends and predictors of hardware related infection following open reduction and internal fixation (ORIF) of extremity fractures, one of the major causes of failure following ORIF. The present study was designed and conducted to determine trends and predictors of infection-related hardware removal following ORIF of extremities using a nationally representative database. Methods: We used Nationwide Inpatient Sample data from ۲۰۰۲ to ۲۰۱۱ to identify cases of ORIF following upper and lower extremity fractures, as well as cases that underwent infection-related hardware removal following ORIF. Multivariate analysis was performed to identify independent predictors of infection-related hardware removal, controlling for patient demographics and comorbidities, hospital characteristics, site of fracture, and year. Results: For all ORIF procedures, the highest rate of hardware removal related to infection was observed in tarsal fractures (۵.۵۶%), followed by tibial (۳.۶۵%) and carpal (۳.۳۷%) fractures. Hardware removal rates due to infection increased in all fractures except radial/ulnar fractures. Tarsal fractures(odds ratio (OR)=۱.۰۶, ۹۵% confidence interval (CI): ۱.۰۴-۱.۰۹, P<۰.۰۰۱), tibial fractures (OR=۱.۰۴, ۹۵% CI: ۱.۰۳-۱.۰۶, P <۰.۰۰۱) and those patients with diabetes mellitus (OR=۲.۶۴, ۹۵% CI: ۲.۴۶-۲.۸۴, P<۰.۰۰۱), liver disease (OR=۲.۰۴, ۹۵% CI: ۱.۸۴- ۲.۲۶, P <۰.۰۰۱), and rheumatoid arthritis (OR=۲.۰۶, ۹۵% CI:۱.۸۸-۲.۲۵ P <۰.۰۰۱) were the main predictors of infection-related removals; females were less likely to undergo removal due to infection (OR= ۰.۶۱, ۹۵% CI: ۰.۵۹-۰.۶۳ P <۰.۰۰۱). Conclusions: Hardware removal rates due to infection increased in all fractures except radial/ulnar fractures. Diabetes, liver disease, and rheumatoid arthritis were important predictors of infection-related hardware removal. The study identified some risk factors for hardwarerelated infection following ORIF, such as diabetes, liver disease, and rheumatoid arthritis,that should be studied further in an attempt to implement strategies to reduce rate of infection following ORIF.
کلیدواژه ها:
نویسندگان
Mohammad Rasouli
The Rothman Institute at Thomas Jefferson University, Philadelphia, PA Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
Jessica Viola
The Rothman Institute at Thomas Jefferson University, Philadelphia, PA
Mitchell Maltenfort
The Rothman Institute at Thomas Jefferson University, Philadelphia, PA
Alisina Shahi
The Rothman Institute at Thomas Jefferson University, Philadelphia, PA
Javad Parvizi
The Rothman Institute at Thomas Jefferson University, Philadelphia, PA
James Krieg
The Rothman Institute at Thomas Jefferson University, Philadelphia, PA
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