Factors associated with infection after reconstructive shoulder surgery for proximal humerus tumors
| Autor: | Santiago A. Lozano Calderón, Nuno Rui Paulino Pereira, Sjoerd P. F. T. Nota, Marco Ferrone, Joseph H. Schwab, Sjoerd Th. Meijer |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Proximal humerus Shoulder surgery medicine.medical_treatment Bone Neoplasms Infections Arthroplasty Hemoglobins 03 medical and health sciences Postoperative Complications 0302 clinical medicine Risk Factors Prevalence Humans Transplantation Homologous Medicine Orthopedics and Sports Medicine Serum Albumin Aged Proportional Hazards Models Retrospective Studies 030222 orthopedics Bone Transplantation Shoulder Joint business.industry Proportional hazards model Risk of infection Albumin General Medicine Perioperative Middle Aged Surgery 030220 oncology & carcinogenesis Preoperative Period Humeral Head Female Preoperative hemoglobin business Complication |
| Zdroj: | Journal of Shoulder and Elbow Surgery. 26:931-938 |
| ISSN: | 1058-2746 |
| DOI: | 10.1016/j.jse.2016.10.014 |
| Popis: | Background The main reconstruction techniques for proximal humerus tumors include osteoarticular allografts (OAs), endoprostheses (EPs), or allograft prosthetic composites (APCs). A common complication is infection, and constructs involving the use of allografts are believed to be at a higher risk of infection. Literature comparing infection rates between different modalities of reconstruction is scarce and underpowered. The study purposes were (1) to determine and compare the prevalence of infection in patients who underwent reconstruction of the proximal humerus including OAs, EPs, and APCs; (2) to identify preoperative, perioperative, and postoperative predictors of infection that might be modifiable; and (3) to present our protocol of treatment in patients with superficial and deep infections. Methods We reviewed 150 patients of all ages with proximal humerus tumors treated by an OA, EP, or APC at 2 tertiary institutions. The prevalence of infection for each modality was calculated and compared between groups. We identified potential predictors of infection with stepwise backward multivariate Cox regression analysis. Results An infection developed in 19 patients (12%): 5 of 45 (11%) in the OA group, 12 of 85 (14%) in the EP group, and 2 of 20 (10%) in the APC group ( P = .740). A lower preoperative hemoglobin blood level and low preoperative albumin blood level were independently associated with infection. Conclusions We found similar infection rates compared with previously reported series. However, we did not identify a higher infection prevalence in constructs using allografts. Patients with a lower preoperative hemoglobin or albumin level are at higher risk of infection and should undergo optimization before surgery. |
| Databáze: | OpenAIRE |
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