Risk Factors for Infection Following Operative Treatment of Traumatic Upper Extremity Amputation Injury

Area of Science:

• Orthopedic Surgery
• Infectious Disease
• Trauma Surgery

Background:

• Surgical site infection (SSI) prevention is key in reducing healthcare costs and improving patient outcomes.
• Limited research exists on specific SSI risk factors following traumatic upper extremity amputations.
• This study addresses the gap by investigating SSI predictors in this patient population.

Purpose of the Study:

• To identify significant risk factors associated with surgical site infection (SSI) after traumatic upper extremity amputation.
• To utilize a large nationwide database for robust statistical analysis.
• To inform clinical practice for improved SSI prevention strategies.

Main Methods:

• Analysis of data from the Japan Trauma Data Bank.
• Multivariate logistic regression and propensity score (PS) matching to identify independent risk factors.
• Receiver operating characteristic (ROC) curve analysis to determine risk thresholds for Injury Severity Score (ISS) and systolic blood pressure (BP).

Main Results:

• Out of 1,150 patients, 21 (1.8%) developed SSI.
• Independent risk factors identified: higher ISS, blood transfusion, elevated systolic BP (>160 mmHg), and upper extremity amputation (excluding fingers).
• PS matching confirmed blood transfusion and systolic BP >160 mmHg as significant predictors of SSI.

Conclusions:

• Patients with traumatic upper extremity amputations and risk factors like high ISS, blood transfusion, or elevated systolic BP require meticulous surgical care.
• Emphasis on thorough debridement and diligent wound management is critical for these high-risk individuals.
• Findings provide evidence-based guidance for preventing SSI in this specific trauma subgroup.