title: Incidence and risk factors for acute infection after proximal humeral fractures: a multicenter study.
abstract: BACKGROUND
  The rate of acute infection after surgery for proximal humeral fractures is not known. The aims of this study were to report the incidence and to analyze the risk factors for infection after proximal humeral fracture treatment.
  
  
  METHODS
  We report a retrospective multicenter study of 452 proximal humeral fractures. Data were modeled by use of univariate and/or linear regression analyses to determine the odds ratio (OR). A logistic regression analysis was used to check for demographic and other characteristics with the potential to confound a true association between risk factors and infection.
  
  
  RESULTS
  The mean age was 62.1 years, and 314 patients were female patients. Of the patients, 18 (4%) had an acute infection. The factors that correlated with infection were length of surgery (OR, 1.009; P = .05), preoperative skin preparation with chlorhexidine gluconate (OR, 0.13; P = .008), and prophylactic antibiotic (OR, 10.73; P = .03). The delay to surgery was close to achieving significance (OR, 1.71; P = .06).
  
  
  CONCLUSIONS
  This study suggests that washing the shoulder with chlorhexidine gluconate and avoiding the use of first-generation cephalosporin in favor of more effective prophylactic therapy are effective at reducing the risk of infection after treatment for proximal humeral fractures.
authors.affiliation: Department of Orthopaedics and Traumatology, Mauriziano-Umberto I Hospital, University of Turin Medical School, Torino, Italy. Electronic address: davide.blonna@virgilio.it.
authors.forename: Davide
authors.initials: D
authors.lastname: Blonna
authors.affiliation: Department of Orthopaedics and Traumatology, Mauriziano-Umberto I Hospital, University of Turin Medical School, Torino, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Barbasetti
authors.affiliation: Department of Public Health and Microbiology, University of Turin Medical School, Torino, Italy.
authors.forename: Giuliana
authors.initials: G
authors.lastname: Banche
authors.affiliation: Department of Public Health and Microbiology, University of Turin Medical School, Torino, Italy.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Cuffini
authors.affiliation: Department of Orthopaedics and Traumatology, San Luigi Gonzaga Hospital, University of Turin Medical School, Orbassano, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Bellato
authors.affiliation: Department of Orthopaedics and Traumatology, San Luigi Gonzaga Hospital, University of Turin Medical School, Orbassano, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Massè
authors.affiliation: Department of Traumatology, CTO-Maria Adelaide Hospital, University of Turin Medical School, Torino, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Marenco
authors.affiliation: Department of Traumatology, CTO-Maria Adelaide Hospital, University of Turin Medical School, Torino, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Battiston
authors.affiliation: Department of Orthopaedics and Traumatology, Mauriziano-Umberto I Hospital, University of Turin Medical School, Torino, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Castoldi
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005592:Fracture Fixation / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D012784:Shoulder Fractures / Q000601:surgery*; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000382:microbiology / Q000628:therapy; D055815:Young Adult
keywords: Proximal humeral fracture; delay of surgery; infection; logistic regression analysis; osteosynthesis; percutaneous fixation; plate fixation