Risk Factors for Surgical Site Infections Following Anterior Cruciate Ligament Reconstruction
| Autor: | Michael V. Murphy, Robert L. Davis, Michael Klompas, Cynthia Nakasato, Mayur Ramesh, Wei Hua, Michael Schum, Craig Zinderman, Thomas A. DeCoster, Laura Johnson, Melissa G. Butler, James D. Nordin, Karoll J. Cortez, Ann Von Worley, Richard Platt, Lingling Li, Dongyi Tony Du |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Microbiology (medical) medicine.medical_specialty Adolescent Anterior cruciate ligament reconstruction Epidemiology Anterior cruciate ligament medicine.medical_treatment Population Young Adult 03 medical and health sciences Sex Factors 0302 clinical medicine Patellar Ligament Risk Factors Humans Surgical Wound Infection Medicine Child education Retrospective Studies 030222 orthopedics education.field_of_study Bone Transplantation Anterior Cruciate Ligament Reconstruction business.industry Patellar ligament Medical record Age Factors Infant Retrospective cohort study 030229 sport sciences Odds ratio musculoskeletal system Surgery surgical procedures operative Infectious Diseases medicine.anatomical_structure Child Preschool Female business Hamstring |
| Zdroj: | Infection Control & Hospital Epidemiology. 37:827-833 |
| ISSN: | 1559-6834 0899-823X |
| DOI: | 10.1017/ice.2016.65 |
| Popis: | OBJECTIVETo determine the effect of graft choice (allograft, bone-patellar tendon-bone autograft, or hamstring autograft) on deep tissue infections following anterior cruciate ligament (ACL) reconstructions.DESIGNRetrospective cohort study.SETTING AND POPULATIONPatients from 6 US health plans who underwent ACL reconstruction from January 1, 2000, through December 31, 2008.METHODSWe identified ACL reconstructions and potential postoperative infections using claims data. A hierarchical stratified sampling strategy was used to identify patients for medical record review to confirm ACL reconstructions and to determine allograft vs autograft tissue implanted, clinical characteristics, and infection status. We estimated infection rates overall and by graft type. We used logistic regression to assess the association between infections and patients’ demographic characteristics, comorbidities, and choice of graft.RESULTSOn review of 1,452 medical records, we found 55 deep wound infections. With correction for sampling weights, infection rates varied by graft type: 0.5% (95% CI, 0.3%-0.8%) with allografts, 0.6% (0.1%–1.5%) with bone-patellar tendon-bone autografts, and 2.5% (1.9%–3.1%) with hamstring autograft. After adjusting for potential confounders, we found an increased infection risk with hamstring autografts compared with allografts (odds ratio, 5.9; 95% CI, 2.8–12.8). However, there was no difference in infection risk among bone-patellar tendon-bone autografts vs allografts (odds ratio, 1.2; 95% CI, 0.3–4.8).CONCLUSIONSThe overall risk for deep wound infections following ACL reconstruction is low but it does vary by graft type. Infection risk was highest in hamstring autograft recipients compared with allograft recipients and bone-patellar tendon-bone autograft recipients.Infect Control Hosp Epidemiol 2016;37:827–833 |
| Databáze: | OpenAIRE |
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