title: The contribution of open extremity fractures to infection in multiply injured patients.
abstract: We sought to determine whether a contaminated open fracture was a reliable component for calculating the Outcome Predictive Score in patients with multiple injuries. We studied 41 patients whose primary source of contamination was open extremity fractures. Only one of the 41 patients developed osteomyelitis. The rate of infection from an open fracture is minimal in the multiply injured patient. Inclusion of patients with open fractures in studies that assess the likelihood of infection and the value of anti-infective agents incorrectly identified patients for clinical trials and results in an overestimation of survival based on the Outcome Predictive Score. These findings suggest that open fractures should be excluded as an entry criterion in future clinical trials.
authors.affiliation: Department of Surgery, University of Louisville School of Medicine, KY.
authors.forename: W
authors.initials: W
authors.lastname: Naziri
authors.forename: W G
authors.initials: WG
authors.lastname: Cheadle
authors.forename: D H
authors.initials: DH
authors.lastname: Livingston
authors.forename: J L
authors.initials: JL
authors.lastname: Rodriguez
authors.forename: K M
authors.initials: KM
authors.lastname: Starko
authors.forename: H C
authors.initials: HC
authors.lastname: Polk
mesh_terms: D001424:Bacterial Infections / Q000209:etiology / Q000517:prevention & control*; D004311:Double-Blind Method; D005264:Femoral Fractures / Q000150:complications; D005597:Fractures, Open / Q000150:complications*; D006801:Humans; D007371:Interferon-gamma / Q000627:therapeutic use*; D009104:Multiple Trauma / Q000150:complications*; D011446:Prospective Studies; D013978:Tibial Fractures / Q000150:complications; D015599:Trauma Severity Indices
chemical_list: D007371:Interferon-gamma