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Factors Associated With the Development of a Confirmed Fracture-Related Infection
Sara Solasz1, Lauren Merrell, Abhishek Ganta
1NYU Langone Orthopedic Hospital, NYU Langone Health, New York, NY.
Objectives:
To identify factors associated with the development of fracture-related infection (FRI) in patients who have undergone operative fixation of their fracture.
Design:
Retrospective study.
Setting:
Academic medical center.
Patients/Participants:
Patients with peripheral extremity long-bone fractures and shoulder and pelvic girdle fractures who underwent operative repair. This included patients who had undergone fixation inside and outside of our institution.
Intervention:
Chi-square, Fisher exact testing, analysis of variance (ANOVA), and t tests were used for analysis of data, as appropriate. Binomial logistic regression analysis was performed to determine risk factors of FRI.
Main Outcome Measurements:
Demographics, fracture location, injury mechanism, open wound status, and wound complication type.
Results:
One hundred ninety-three patients comprised the FRI cohort. Of those with confirmed signs of FRI, 36 (18.7%) had wound breakdown to bone or implant, 120 (62.1%) had a sinus track, and 170 patients (88.1%) had the confirmed presence of microorganisms in deep tissue samples obtained during operative intervention. Factors associated with development of an FRI were as follows: higher BMI; being of Black and Hispanic race; higher American Society of Anesthesiologists class; history of tobacco, alcohol, and drug use; and fractures of the lower extremity (foot, tibia, and femur/pelvis). The results of binary logistic regression demonstrated that treatment at an urban level I trauma center and drug use positively predicted the development of FRI.
Conclusion:
Our results demonstrate that higher BMI; being of Black or Hispanic race; higher American Society of Anesthesiologists; history of tobacco, alcohol, and drug use; and fractures of the foot, tibia, and femur/pelvis are all factors associated with development of FRI.
Level Of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
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