Subcutaneous Radiographic Measurement: A Marker to Evaluate Surgical Site Infection Risk in Elderly Hip Fracture Patients
<p class="p p-first" id="__p2"><strong>Objectives:</strong> Obesity is a documented comorbidity that is prevalent in the elderly population and a known predictor for surgical site infection (SSI). Body mass index is a convenient method to classify obesity, but i...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Copernicus Publications
2019-01-01
|
| Series: | Journal of Bone and Joint Infection |
| Online Access: | https://jbji.copernicus.org/articles/4/27/2019/jbji-4-27-2019.pdf |
| _version_ | 1818351650344009728 |
|---|---|
| author | M. Bernaus F. Anglès F. Anglès B. Escudero M. Veloso A. Matamala L. Font-Vizcarra |
| author_facet | M. Bernaus F. Anglès F. Anglès B. Escudero M. Veloso A. Matamala L. Font-Vizcarra |
| author_sort | M. Bernaus |
| collection | DOAJ |
| description | <p class="p p-first" id="__p2"><strong>Objectives:</strong> Obesity is a documented comorbidity that is prevalent in the elderly population and a known predictor for surgical site infection (SSI). Body mass index is a convenient method to classify obesity, but it fails to account for fat distribution. The objective of our study was to evaluate the association between surgical site infection and a subcutaneous radiographic measurement (SRM) in elderly hip fracture patients.</p><p id="__p3"><strong>Materials and Methods:</strong> A retrospective case-control study was conducted to compare SRMs at the hip in patients diagnosed with surgical site infection after hip fracture surgery with patients that were not diagnosed with surgical site infection. Each case was matched to two controls. An SRM was defined as the distance from the tip of the greater trochanter to the skin following a perpendicular line to the femoral diaphysis in anteroposterior hip radiographs. Clinical diagnosis of acute surgical site infection was based on Tsukayama criteria.</p><p id="__p4"><strong>Results:</strong> Patients with an SRM greater than 6.27cm had a 7-fold increase in the odds of surgical site infection (OR=7.42, 95% Confidence Interval (CI)=3.01-18.28, p<0.001) compared to those with smaller measurements. The odds ratio (OR) for infection of patients with an ASA score of 3 was 15.82(95% CI=5.11-48.9, p-value<0.001)</p><p id="__p5">A statistically significant difference between cases and controls was also found when SRM at the hip was analyzed as a continuous variable. Patients with an infection had a 2.24cm (95% CI=1.59 - 2.90; p<0.001) greater mean SRM.</p><p class="p p-last" id="__p6"><strong>Conclusion:</strong> Results of our study suggest an association between the SRM at the hip and the risk of SSI in elderly patients with surgically treated hip fractures. SRM may be a helpful tool for evaluating the risk of SSI in elderly hip fracture patients.</p> |
| first_indexed | 2024-12-13T18:41:07Z |
| format | Article |
| id | doaj.art-e60bfb3cf5254bb0a4c563af56af5894 |
| institution | Directory Open Access Journal |
| issn | 2206-3552 |
| language | English |
| last_indexed | 2024-12-13T18:41:07Z |
| publishDate | 2019-01-01 |
| publisher | Copernicus Publications |
| record_format | Article |
| series | Journal of Bone and Joint Infection |
| spelling | doaj.art-e60bfb3cf5254bb0a4c563af56af58942022-12-21T23:35:13ZengCopernicus PublicationsJournal of Bone and Joint Infection2206-35522019-01-014273210.7150/jbji.30158Subcutaneous Radiographic Measurement: A Marker to Evaluate Surgical Site Infection Risk in Elderly Hip Fracture PatientsM. Bernaus0F. Anglès1F. Anglès2B. Escudero3M. Veloso4A. Matamala5L. Font-Vizcarra6Department of Traumatology and Orthopedic Surgery, Hospital Universitari Mútua Terrassa, Barcelona, SpainDepartment of Traumatology and Orthopedic Surgery, Hospital Universitari Mútua Terrassa, Barcelona, SpainDepartment of Surgery, Universitat de BarcelonaDepartment of Traumatology and Orthopedic Surgery, Hospital Universitari Mútua Terrassa, Barcelona, SpainDepartment of Traumatology and Orthopedic Surgery, Hospital Universitari Mútua Terrassa, Barcelona, SpainDepartment of Traumatology and Orthopedic Surgery, Hospital Universitari Mútua Terrassa, Barcelona, SpainDepartment of Traumatology and Orthopedic Surgery, Hospital Universitari Mútua Terrassa, Barcelona, Spain<p class="p p-first" id="__p2"><strong>Objectives:</strong> Obesity is a documented comorbidity that is prevalent in the elderly population and a known predictor for surgical site infection (SSI). Body mass index is a convenient method to classify obesity, but it fails to account for fat distribution. The objective of our study was to evaluate the association between surgical site infection and a subcutaneous radiographic measurement (SRM) in elderly hip fracture patients.</p><p id="__p3"><strong>Materials and Methods:</strong> A retrospective case-control study was conducted to compare SRMs at the hip in patients diagnosed with surgical site infection after hip fracture surgery with patients that were not diagnosed with surgical site infection. Each case was matched to two controls. An SRM was defined as the distance from the tip of the greater trochanter to the skin following a perpendicular line to the femoral diaphysis in anteroposterior hip radiographs. Clinical diagnosis of acute surgical site infection was based on Tsukayama criteria.</p><p id="__p4"><strong>Results:</strong> Patients with an SRM greater than 6.27cm had a 7-fold increase in the odds of surgical site infection (OR=7.42, 95% Confidence Interval (CI)=3.01-18.28, p<0.001) compared to those with smaller measurements. The odds ratio (OR) for infection of patients with an ASA score of 3 was 15.82(95% CI=5.11-48.9, p-value<0.001)</p><p id="__p5">A statistically significant difference between cases and controls was also found when SRM at the hip was analyzed as a continuous variable. Patients with an infection had a 2.24cm (95% CI=1.59 - 2.90; p<0.001) greater mean SRM.</p><p class="p p-last" id="__p6"><strong>Conclusion:</strong> Results of our study suggest an association between the SRM at the hip and the risk of SSI in elderly patients with surgically treated hip fractures. SRM may be a helpful tool for evaluating the risk of SSI in elderly hip fracture patients.</p>https://jbji.copernicus.org/articles/4/27/2019/jbji-4-27-2019.pdf |
| spellingShingle | M. Bernaus F. Anglès F. Anglès B. Escudero M. Veloso A. Matamala L. Font-Vizcarra Subcutaneous Radiographic Measurement: A Marker to Evaluate Surgical Site Infection Risk in Elderly Hip Fracture Patients Journal of Bone and Joint Infection |
| title | Subcutaneous Radiographic Measurement: A Marker to Evaluate Surgical Site Infection Risk in Elderly Hip Fracture Patients |
| title_full | Subcutaneous Radiographic Measurement: A Marker to Evaluate Surgical Site Infection Risk in Elderly Hip Fracture Patients |
| title_fullStr | Subcutaneous Radiographic Measurement: A Marker to Evaluate Surgical Site Infection Risk in Elderly Hip Fracture Patients |
| title_full_unstemmed | Subcutaneous Radiographic Measurement: A Marker to Evaluate Surgical Site Infection Risk in Elderly Hip Fracture Patients |
| title_short | Subcutaneous Radiographic Measurement: A Marker to Evaluate Surgical Site Infection Risk in Elderly Hip Fracture Patients |
| title_sort | subcutaneous radiographic measurement a marker to evaluate surgical site infection risk in elderly hip fracture patients |
| url | https://jbji.copernicus.org/articles/4/27/2019/jbji-4-27-2019.pdf |
| work_keys_str_mv | AT mbernaus subcutaneousradiographicmeasurementamarkertoevaluatesurgicalsiteinfectionriskinelderlyhipfracturepatients AT fangles subcutaneousradiographicmeasurementamarkertoevaluatesurgicalsiteinfectionriskinelderlyhipfracturepatients AT fangles subcutaneousradiographicmeasurementamarkertoevaluatesurgicalsiteinfectionriskinelderlyhipfracturepatients AT bescudero subcutaneousradiographicmeasurementamarkertoevaluatesurgicalsiteinfectionriskinelderlyhipfracturepatients AT mveloso subcutaneousradiographicmeasurementamarkertoevaluatesurgicalsiteinfectionriskinelderlyhipfracturepatients AT amatamala subcutaneousradiographicmeasurementamarkertoevaluatesurgicalsiteinfectionriskinelderlyhipfracturepatients AT lfontvizcarra subcutaneousradiographicmeasurementamarkertoevaluatesurgicalsiteinfectionriskinelderlyhipfracturepatients |