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Risk Factors of Reese et al for Surgical Site Infection Following Long Bone Fracture

Description

Reese et al reported risk factors for a surgical site infection (SSI) following a long bone fracture. These can help to identify a patient who may benefit from more aggressive management. The authors are from the Denver Health Medical Center and University of Colorado.


Patient selection: long bone fracture treated with open reduction internal fixation (ORIF)

 

Outcome: surgical site infection (as manifested by purulent drainage, other signs of infection, positive culture or identification of an abscess on wound exploration)

 

Risk factors for a surgical site infection from the multivariate analysis:

(1) history of methicillin-resistant Staphylococcus aureus (MRSA; odds ratio 7.2)

(2) lower leg fracture (odds ratio 2.6)

(3) ASA 3 or 4 (odds ratio 2.1; ASA 5 also in Table 3)

(4) open fracture (odds ratio 1.9)

 

The risk of SSI increases with the number of risk factors present.

 

Additional factors from univariate analysis implicated in previous studies:

(1) older age

(2) diabetes

(3) estimated blood loss

(4) gender

(5) alcohol use

(6) prior external fixator


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