title: A Population-Based 16-Year Study on the Risk Factors of Surgical Site Infection in Patients after Bone Grafting: A Cross-Sectional Study in Taiwan.
abstract: Bone grafting is a commonly used orthopedic surgical procedure that will provide bone formation in bone defects or regions of defective bone healing. A major complication following bone grafting is a postoperative recipient graft site infection that is associated with substantial mortality and increased use of medical resources. The purpose of the study was to identify the risk factors associated with infection after bone-grafting surgery.Data from 1,303,347 patients listed in the Taiwan National Health Insurance Research Database (NHIRD) and admitted to hospitals from 1997 through 2012 who underwent primary bone grafting (mean age: 46.57 years old; mean length of hospital stay: 8.04 days) were analyzed. The incidence of infection by age, hospital stay, gender, income, chronic disease (tuberculosis [TB]; diabetes mellitus [DM]; acquired immunodeficiency syndrome [AIDS]), fracture complications (nonunion; delayed union fracture), types of graft and hospital was evaluated.Three percent of the patients developed a postoperative recipient graft site infection. Multivariable analysis revealed that patients were more likely to develop a post bone-grafting surgery infection if they were older, had a longer hospital stay, were male, had a lower income, or had comorbid TB, DM, or AIDS. Patients were more likely to develop an infection if they had a nonunion, an alloplast graft, or treated in a local clinic.Our findings should provide a clinically relevant reference for surgeons who perform bone grafting. Patients should be informed of the potential risks.
authors.affiliation: From the Department of Nursing, Chung Hwa University of Medical Technology (F-HL, J-LH); Department of Orthopedics, Tainan Hospital, Ministry of Health and Welfare (P-CS); Department of Orthopedics, National Cheng Kung University Medical College (I-MJ); Department of Public Health, National Cheng Kung University Medical College, Tainan (C-YL); and Department of Public Health (C-YL), College of Public Health, China Medical University, Taichung, Taiwan.
authors.forename: Fang-Hsin
authors.initials: FH
authors.lastname: Lee
authors.forename: Po-Chuan
authors.initials: PC
authors.lastname: Shen
authors.forename: I-Ming
authors.initials: IM
authors.lastname: Jou
authors.forename: Chung-Yi
authors.initials: CY
authors.lastname: Li
authors.forename: Jeng-Long
authors.initials: JL
authors.lastname: Hsieh
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001847:Bone Diseases / Q000601:surgery; D016025:Bone Transplantation / Q000009:adverse effects* / Q000379:methods / Q000706:statistics & numerical data; D002908:Chronic Disease / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012959:Socioeconomic Factors; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D013624:Taiwan / Q000453:epidemiology