Impact of surgical site infection on patients' outcome after fixation of tibial plateau fractures: a retrospective multicenter study
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Impact of surgical site infection on patients' outcome after fixation of tibial plateau fractures: a retrospective multicenter study. / Henkelmann, Ralf; Glaab, Richard; Mende, Meinhard; Ull, Christopher; Braun, Philipp-Johannes; Katthagen, Christoph; Gensior, Tobias J; Frosch, Karl-Heinz; Hepp, Pierre; Committee TRAUMA of the AGA-Society for Arthroscopy and Joint Surgery.
In: BMC MUSCULOSKEL DIS, Vol. 22, No. 1, 531, 09.06.2021.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Impact of surgical site infection on patients' outcome after fixation of tibial plateau fractures: a retrospective multicenter study
AU - Henkelmann, Ralf
AU - Glaab, Richard
AU - Mende, Meinhard
AU - Ull, Christopher
AU - Braun, Philipp-Johannes
AU - Katthagen, Christoph
AU - Gensior, Tobias J
AU - Frosch, Karl-Heinz
AU - Hepp, Pierre
AU - Committee TRAUMA of the AGA-Society for Arthroscopy and Joint Surgery
PY - 2021/6/9
Y1 - 2021/6/9
N2 - BACKGROUND: Surgical site infection (SSI) occurs in 3-10 % of patients with surgically treated tibial plateau fractures. This study aimed to evaluate the impact of SSI on patients' outcome after fixation of tibial plateau fractures.METHODS: We conducted a retrospective multicenter study in seven participating level I trauma centers between January 2005 and December 2014. All participating centers followed up with patients with SSI. In addition, three centers followed up with patients without SSI as a reference group. Descriptive data and follow-up data with patient-reported outcome scores (Knee Injury and Osteoarthritis Outcome Score [KOOS] and Lysholm knee scoring scale score) were evaluated.RESULTS: In summary, 287 patients (41 with SSI and 246 without SSI; average 50.7 years) with an average follow-up of 75.9 ± 35.9 months were included in this study. Patients with SSI had a significantly poorer overall KOOS (KOOS5) (48.7 ± 23.2 versus [vs.] 71.5 ± 23.5; p < 0.001) and Lysholm knee scoring scale score (51.4 ± 24.0 vs. 71.4 ± 23.5; p < 0.001) than patients without SSI. This significant difference was also evident in the KOOS subscores for pain, symptoms, activities of daily living (ADL), and quality of life (QoL). SSI remained an important factor in multivariable models after adjusting for potential confounders. Clinically relevant differences in the KOOS5 and KOOS subscores for symptoms, pain, and ADL were found between those with SSI and without SSI even after adjustment. Furthermore, the number of previous diseases, Arbeitsgemeinschaft für Osteosynthesefragen Foundation (AO) C fractures, and compartment syndrome were found to be additional factors related to poor outcome.CONCLUSIONS: Compared to previous studies, validated patient-reported outcome scores demonstrated that the impact of SSI in patients with surgically treated tibial plateau fractures is dramatic, in terms of not only pain and symptoms but also in ADL and QoL, compared to that in patients without SSI.
AB - BACKGROUND: Surgical site infection (SSI) occurs in 3-10 % of patients with surgically treated tibial plateau fractures. This study aimed to evaluate the impact of SSI on patients' outcome after fixation of tibial plateau fractures.METHODS: We conducted a retrospective multicenter study in seven participating level I trauma centers between January 2005 and December 2014. All participating centers followed up with patients with SSI. In addition, three centers followed up with patients without SSI as a reference group. Descriptive data and follow-up data with patient-reported outcome scores (Knee Injury and Osteoarthritis Outcome Score [KOOS] and Lysholm knee scoring scale score) were evaluated.RESULTS: In summary, 287 patients (41 with SSI and 246 without SSI; average 50.7 years) with an average follow-up of 75.9 ± 35.9 months were included in this study. Patients with SSI had a significantly poorer overall KOOS (KOOS5) (48.7 ± 23.2 versus [vs.] 71.5 ± 23.5; p < 0.001) and Lysholm knee scoring scale score (51.4 ± 24.0 vs. 71.4 ± 23.5; p < 0.001) than patients without SSI. This significant difference was also evident in the KOOS subscores for pain, symptoms, activities of daily living (ADL), and quality of life (QoL). SSI remained an important factor in multivariable models after adjusting for potential confounders. Clinically relevant differences in the KOOS5 and KOOS subscores for symptoms, pain, and ADL were found between those with SSI and without SSI even after adjustment. Furthermore, the number of previous diseases, Arbeitsgemeinschaft für Osteosynthesefragen Foundation (AO) C fractures, and compartment syndrome were found to be additional factors related to poor outcome.CONCLUSIONS: Compared to previous studies, validated patient-reported outcome scores demonstrated that the impact of SSI in patients with surgically treated tibial plateau fractures is dramatic, in terms of not only pain and symptoms but also in ADL and QoL, compared to that in patients without SSI.
KW - Activities of Daily Living
KW - Fracture Fixation, Internal/adverse effects
KW - Humans
KW - Quality of Life
KW - Retrospective Studies
KW - Surgical Wound Infection/epidemiology
KW - Tibial Fractures/diagnostic imaging
KW - Treatment Outcome
U2 - 10.1186/s12891-021-04402-6
DO - 10.1186/s12891-021-04402-6
M3 - SCORING: Journal article
C2 - 34107953
VL - 22
JO - BMC MUSCULOSKEL DIS
JF - BMC MUSCULOSKEL DIS
SN - 1471-2474
IS - 1
M1 - 531
ER -