Wilkinson et al reported a score for predicting the risk of a deep surgical site infection in a patient with an open tibial shaft fracture treated with an intramedullary nail. This can help to identify a high-risk patient who may benefit from more aggressive management. The authors are from the University of Maryland.
Patient selection: open tibial shaft fracture with intramedullary nail
Outcome: deep infection requiring surgical debridement
Parameters:
(1) age in years
(2) ASA score
(3) Gustilo-Anderson classification of the fracture
(4) gunshot wound
Parameter
Finding
Points
age in years
<= 40 years
0
> 40 years
5
ASA score
1 or 2
0
3 or more
7
Gustilo-Anderson type
I or II
0
IIIA
10
IIIB or IIIC
25
gunshot wound
no
0
yes
11
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 48
Total Score
Median RIsk
0 to 10
4%
11 to 20
10%
21 to 30
18%
31 to 40
47%
41 to 48
59%
Performance:
• The C-statistic is 0.79.
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