Gertraud Gradl1, Pieter Bas de Witte2, Brady T Evans3, Francis Hornicek3, Kevin Raskin3, David Ring3. 1. Department of Trauma and Reconstructive Surgery, University of Aachen, Pauwelstrasse 30, 52074 Aachen, Germany. 2. Orthopaedics Department, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands. 3. Hand and Upper Extremity Service (B.T.E. and D.R.) and Orthopaedic Oncology Service (F.H. and K.R.), Department of Orthopaedic Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114. E-mail address for D. Ring: DRING@PARTNERS.ORG.
Abstract
BACKGROUND: This study addressed risk factors for surgical site infection in patients who had undergone orthopaedic oncology surgical procedures. METHODS: We retrospectively reviewed data on 1521 orthopaedic oncologic surgical procedures in 1304 patients. We assessed patient demographics, updated Charlson comorbidity index, surgery-specific data, and treatment-related data and attempted to identify predictors of surgical site infection with bivariate and multivariable analysis. RESULTS: Eight factors independently predicted surgical site infection: body mass index (odds ratio [OR]:, 1.03, 95% confidence interval [CI]: 1.00 to 1.07), age (OR: 1.18, 95% CI: 1.05 to 1.33), total number of preceding procedures (OR: 1.19, 95% CI: 1.07 to 1.34), preexisting implants (OR: 1.94, 95% CI: 1.17 to 3.21), infection at another site on the date of the surgery (OR: 4.13, 95% CI: 1.57 to 10.85), malignant disease (OR: 1.46, 95% CI: 0.94 to 2.26), hip region affected (OR: 1.96, 95% CI: 1.35 to 2.84), and duration of the procedure (OR: 1.16, 95% CI: 1.07 to 1.25). CONCLUSIONS: These factors can inform patients and surgeons of the probability of surgical site infection after orthopaedic oncologic surgery. While most risk factors are unmodifiable or related to the complexity of the case, infection at another site on the date of the surgery is one factor amenable to intervention.
BACKGROUND: This study addressed risk factors for surgical site infection in patients who had undergone orthopaedic oncology surgical procedures. METHODS: We retrospectively reviewed data on 1521 orthopaedic oncologic surgical procedures in 1304 patients. We assessed patient demographics, updated Charlson comorbidity index, surgery-specific data, and treatment-related data and attempted to identify predictors of surgical site infection with bivariate and multivariable analysis. RESULTS: Eight factors independently predicted surgical site infection: body mass index (odds ratio [OR]:, 1.03, 95% confidence interval [CI]: 1.00 to 1.07), age (OR: 1.18, 95% CI: 1.05 to 1.33), total number of preceding procedures (OR: 1.19, 95% CI: 1.07 to 1.34), preexisting implants (OR: 1.94, 95% CI: 1.17 to 3.21), infection at another site on the date of the surgery (OR: 4.13, 95% CI: 1.57 to 10.85), malignant disease (OR: 1.46, 95% CI: 0.94 to 2.26), hip region affected (OR: 1.96, 95% CI: 1.35 to 2.84), and duration of the procedure (OR: 1.16, 95% CI: 1.07 to 1.25). CONCLUSIONS: These factors can inform patients and surgeons of the probability of surgical site infection after orthopaedic oncologic surgery. While most risk factors are unmodifiable or related to the complexity of the case, infection at another site on the date of the surgery is one factor amenable to intervention.
Authors: Matthew T Houdek; Peter C Ferguson; Matthew P Abdel; Anthony M Griffin; Mario Hevesi; Kevin I Perry; Peter S Rose; Jay S Wunder; David G Lewallen Journal: J Bone Joint Surg Am Date: 2020-07-15 Impact factor: 6.558
Authors: Michaël P A Bus; Andrzej Szafranski; Simen Sellevold; Tomasz Goryn; Paul C Jutte; Jos A M Bramer; M Fiocco; Arne Streitbürger; Daniel Kotrych; Michiel A J van de Sande; P D Sander Dijkstra Journal: Clin Orthop Relat Res Date: 2017-03 Impact factor: 4.176