Surgical site infection in orthopaedic oncology.
BACKGROUND
This study addressed risk factors for surgical site infection in patients who had undergone orthopaedic oncology surgical procedures.


METHODS
We retrospectively reviewed data on 1521 orthopaedic oncologic surgical procedures in 1304 patients. We assessed patient demographics, updated Charlson comorbidity index, surgery-specific data, and treatment-related data and attempted to identify predictors of surgical site infection with bivariate and multivariable analysis.


RESULTS
Eight factors independently predicted surgical site infection: body mass index (odds ratio [OR]:, 1.03, 95% confidence interval [CI]: 1.00 to 1.07), age (OR: 1.18, 95% CI: 1.05 to 1.33), total number of preceding procedures (OR: 1.19, 95% CI: 1.07 to 1.34), preexisting implants (OR: 1.94, 95% CI: 1.17 to 3.21), infection at another site on the date of the surgery (OR: 4.13, 95% CI: 1.57 to 10.85), malignant disease (OR: 1.46, 95% CI: 0.94 to 2.26), hip region affected (OR: 1.96, 95% CI: 1.35 to 2.84), and duration of the procedure (OR: 1.16, 95% CI: 1.07 to 1.25).


CONCLUSIONS
These factors can inform patients and surgeons of the probability of surgical site infection after orthopaedic oncologic surgery. While most risk factors are unmodifiable or related to the complexity of the case, infection at another site on the date of the surgery is one factor amenable to intervention.
Department of Trauma and Reconstructive Surgery, University of Aachen, Pauwelstrasse 30, 52074 Aachen, Germany.
Gertraud
G
Gradl
Orthopaedics Department, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands.
Pieter Bas
PB
de Witte
Hand and Upper Extremity Service (B.T.E. and D.R.) and Orthopaedic Oncology Service (F.H. and K.R.), Department of Orthopaedic Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114. E-mail address for D. Ring: DRING@PARTNERS.ORG.
Brady T
BT
Evans
Hand and Upper Extremity Service (B.T.E. and D.R.) and Orthopaedic Oncology Service (F.H. and K.R.), Department of Orthopaedic Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114. E-mail address for D. Ring: DRING@PARTNERS.ORG.
Francis
F
Hornicek
Hand and Upper Extremity Service (B.T.E. and D.R.) and Orthopaedic Oncology Service (F.H. and K.R.), Department of Orthopaedic Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114. E-mail address for D. Ring: DRING@PARTNERS.ORG.
Kevin
K
Raskin
Hand and Upper Extremity Service (B.T.E. and D.R.) and Orthopaedic Oncology Service (F.H. and K.R.), Department of Orthopaedic Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114. E-mail address for D. Ring: DRING@PARTNERS.ORG.
David
D
Ring
D064591:Allografts / Q000706:statistics & numerical data; D001859:Bone Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011878:Radiotherapy / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000209:etiology*