TY - JOUR
T1 - A population-based 16-year study on the risk factors of surgical site infection in patients after bone grafting
AU - Lee, Fang Hsin
AU - Shen, Po Chuan
AU - Jou, I. Ming
AU - Li, Chung Yi
AU - Hsieh, Jeng Long
N1 - Funding Information:
Editor: James Kellam. Received: August 11, 2015; revised: October 10, 2015; accepted: October 16, 2015. From the Department of Nursing, Chung Hwa University of Medical Technology (F-HL, J-LH); Department of Orthopedics, Tainan Hospital, Ministry of Health and Welfare (P-CS); Department of Orthopedics, National Cheng Kung University Medical College (I-MJ); Department of Public Health, National Cheng Kung University Medical College, Tainan (C-YL); and Department of Public Health (C-YL), College of Public Health, China Medical University, Taichung, Taiwan. Correspondence: Jeng-Long Hsieh, Department of Nursing, Chung Hwa University of Medical Technology, 89 Wenhua 1st Street, Rende District, Tainan City 71703, Taiwan (e-mail: pipi58871053@yahoo. com.tw). This study is based in part on data from the NHIRD provided by the National Health Insurance Administration, Ministry of Health and Welfare and managed by National Health Research Institutes. The interpretation and conclusions contained herein do not represent those of National Health Insurance Administration, Ministry of Health and Welfare or National Health Research Institutes. This work was supported by grants from the National Science Council (NSC 102–2314-B-273 -002 -MY3), Taiwan. F-HL and P-CS contributed equally to this article. The authors have no funding and conflicts of interest to disclose. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. This is an open access article distributed under the Creative Commons Attribution-NoDerivatives License 4.0, which allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author. ISSN: 0025-7974 DOI: 10.1097/MD.0000000000002034
Publisher Copyright:
Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2015/11
Y1 - 2015/11
N2 - Bone grafting is a commonly used orthopedic surgical procedure that will provide bone formation in bone defects or regions of defective bone healing. A major complication following bone grafting is a postoperative recipient graft site infection that is associated with substantial mortality and increased use of medical resources. The purpose of the study was to identify the risk factors associated with infection after bone-grafting surgery. Data from 1,303,347 patients listed in the Taiwan National Health Insurance Research Database (NHIRD) and admitted to hospitals from 1997 through 2012 who underwent primary bone grafting (mean age: 46.57 years old; mean length of hospital stay: 8.04 days) were analyzed. The incidence of infection by age, hospital stay, gender, income, chronic disease (tuberculosis [TB]; diabetes mellitus [DM]; acquired immunodeficiency syndrome [AIDS]), fracture complications (nonunion; delayed union fracture), types of graft and hospital was evaluated. Three percent of the patients developed a postoperative recipient graft site infection. Multivariable analysis revealed that patients were more likely to develop a post bone-grafting surgery infection if they were older, had a longer hospital stay, were male, had a lower income, or had comorbid TB, DM, or AIDS. Patients were more likely to develop an infection if they had a nonunion, an alloplast graft, or treated in a local clinic. Our findings should provide a clinically relevant reference for surgeons who perform bone grafting. Patients should be informed of the potential risks.
AB - Bone grafting is a commonly used orthopedic surgical procedure that will provide bone formation in bone defects or regions of defective bone healing. A major complication following bone grafting is a postoperative recipient graft site infection that is associated with substantial mortality and increased use of medical resources. The purpose of the study was to identify the risk factors associated with infection after bone-grafting surgery. Data from 1,303,347 patients listed in the Taiwan National Health Insurance Research Database (NHIRD) and admitted to hospitals from 1997 through 2012 who underwent primary bone grafting (mean age: 46.57 years old; mean length of hospital stay: 8.04 days) were analyzed. The incidence of infection by age, hospital stay, gender, income, chronic disease (tuberculosis [TB]; diabetes mellitus [DM]; acquired immunodeficiency syndrome [AIDS]), fracture complications (nonunion; delayed union fracture), types of graft and hospital was evaluated. Three percent of the patients developed a postoperative recipient graft site infection. Multivariable analysis revealed that patients were more likely to develop a post bone-grafting surgery infection if they were older, had a longer hospital stay, were male, had a lower income, or had comorbid TB, DM, or AIDS. Patients were more likely to develop an infection if they had a nonunion, an alloplast graft, or treated in a local clinic. Our findings should provide a clinically relevant reference for surgeons who perform bone grafting. Patients should be informed of the potential risks.
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U2 - 10.1097/MD.0000000000002034
DO - 10.1097/MD.0000000000002034
M3 - Article
C2 - 26632703
AN - SCOPUS:84979850766
VL - 94
SP - e2034
JO - Medicine (United States)
JF - Medicine (United States)
SN - 0025-7974
IS - 47
ER -
