Journal of clinical orthopaedics and trauma · 2025
Risk factors associated with nosocomial infections in pelvic ring and acetabular fractures: A case-control study.
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Bodu-Lamberti Edgar Manuel, Fetecua-Chaparro Juanita, Olivella Gómez Juan, Karduss-Preciado Camila, Navarro Gutierrez Nicoll, Ortiz-Martinez Juan Guillermo
Аннотация
BACKGROUND: To identify potential risk factors associated with the development of nosocomial infections in patients with pelvic ring and acetabular fractures.
METHODS: A case-control study was conducted at a tertiary trauma centre in Colombia, from January 2019 to May 2024. Patients with ICD-10 codes corresponding to pelvic ring and acetabular fractures were selected. After the application of inclusion and exclusion criteria, a final sample of 103 eligible participants was obtained. Qualitative and quantitative variables were analysed by standard methods. Odds ratios with 95 % confidence intervals were calculated using cross-tabulations. Statistical significance was determined using a two-tailed t-test with a threshold of 0.05 and ROC analyses were implemented.
RESULTS: Mean age of the study population was 45.3 ± 20.61 years, consisting mostly of males (n = 68, 66.01 %) and road traffic accidents (n = 53, 51.45 %). The overall rate of infection was 22.3 % (n = 23), led by tracheitis (n = 9, 8.73 %), catheter associated UTI (n = 8, 7.76 %) and surgical site infection (n = 7, 6.79 %). Among independent predictors, the best performing variables were hospital LOS, ISS, creatinine, and ICU LOS (AUCs 0.88-0.78). Two deaths (1.94 %) were recorded in the infected subgroup at 10 and 34 days after admission.
CONCLUSION: Pelvic ring and acetabular fractures are linked to high rates of infectious complications, due to high-energy trauma, prolonged hospital stays and acute kidney failure. Recognizing these associations can inform early clinical decision-making and resource allocation, ultimately improving patient outcomes.
METHODS: A case-control study was conducted at a tertiary trauma centre in Colombia, from January 2019 to May 2024. Patients with ICD-10 codes corresponding to pelvic ring and acetabular fractures were selected. After the application of inclusion and exclusion criteria, a final sample of 103 eligible participants was obtained. Qualitative and quantitative variables were analysed by standard methods. Odds ratios with 95 % confidence intervals were calculated using cross-tabulations. Statistical significance was determined using a two-tailed t-test with a threshold of 0.05 and ROC analyses were implemented.
RESULTS: Mean age of the study population was 45.3 ± 20.61 years, consisting mostly of males (n = 68, 66.01 %) and road traffic accidents (n = 53, 51.45 %). The overall rate of infection was 22.3 % (n = 23), led by tracheitis (n = 9, 8.73 %), catheter associated UTI (n = 8, 7.76 %) and surgical site infection (n = 7, 6.79 %). Among independent predictors, the best performing variables were hospital LOS, ISS, creatinine, and ICU LOS (AUCs 0.88-0.78). Two deaths (1.94 %) were recorded in the infected subgroup at 10 and 34 days after admission.
CONCLUSION: Pelvic ring and acetabular fractures are linked to high rates of infectious complications, due to high-energy trauma, prolonged hospital stays and acute kidney failure. Recognizing these associations can inform early clinical decision-making and resource allocation, ultimately improving patient outcomes.