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Thickness of the Subcutaneous Fat as a Risk Factor for Surgical Site Infection Following Fragility Hip Fracture Surgery

INTRODUCTION: Surgical site infection (SSI) following fragility hip fracture (FHF) surgery is associated with increased morbidity and mortality. SIGNIFICANCE: Prediction of patients at risk for SSI is fundamental. We aimed to determine whether subcutaneous radiographic fat measurement (SRM) is assoc...

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Autores principales: Frenkel Rutenberg, Tal, Markman, Rotem, Rutenberg, Ran, Daglan, Efrat, Rubin, Tomer, Shemesh, Shai
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8874187/
https://www.ncbi.nlm.nih.gov/pubmed/35223132
http://dx.doi.org/10.1177/21514593221080272
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author Frenkel Rutenberg, Tal
Markman, Rotem
Rutenberg, Ran
Daglan, Efrat
Rubin, Tomer
Shemesh, Shai
author_facet Frenkel Rutenberg, Tal
Markman, Rotem
Rutenberg, Ran
Daglan, Efrat
Rubin, Tomer
Shemesh, Shai
author_sort Frenkel Rutenberg, Tal
collection PubMed
description INTRODUCTION: Surgical site infection (SSI) following fragility hip fracture (FHF) surgery is associated with increased morbidity and mortality. SIGNIFICANCE: Prediction of patients at risk for SSI is fundamental. We aimed to determine whether subcutaneous radiographic fat measurement (SRM) is associated with increased SSI risk. METHODS: A retrospective case-control comparison of SRMs at 3 locations around the hip. Patients diagnosed with SSI in the first post-operative year were matched with age, gender, surgical year, Charlsons’ co-morbidity index score, and surgical type controls, not diagnosed with SSI, at a 1:2 ratio. Measurements included the distance between (1) the sourcil to skin surface (SS), (2) the tip of the greater trochanter to skin surface (TGTS), and (3) the most prominent lateral aspect of the greater trochanter to skin surface. RESULTS: 1430 patients were operated during the study period, of whom 45 patients presented with a diagnosis of SSI and compared to 90 controls. Infections occurred 27.4 ( ± 24.8) days following surgery. SRM significantly differed between groups, and all were higher in the study group; SS, 86.8 ± 25.5 cm vs 74.2 ± 15.3 cm; TGTS, 59.8 ± 26.3 cm vs 47.0 ± 15.8 cm; and LGTS, 45.4 ± 25.1 cm vs 33.2 ± 15.1 cm (P = .003, .004, and .004, respectively). Intraclass correlation coefficients (intra-rater) were high for all measurements (.999 for all). Intraclass correlation coefficients (inter-rater) for SS, TGTS and LGTS were high, .749 (.663.815), .792 (.719.847) and .817 (.751.866), respectively. CONCLUSIONS: SRMs were found to be a valid and reproducible tool for predicting high risk of SSI in geriatric patients sustaining FHFs. LEVEL OF EVIDENCE: III.
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spelling pubmed-88741872022-02-26 Thickness of the Subcutaneous Fat as a Risk Factor for Surgical Site Infection Following Fragility Hip Fracture Surgery Frenkel Rutenberg, Tal Markman, Rotem Rutenberg, Ran Daglan, Efrat Rubin, Tomer Shemesh, Shai Geriatr Orthop Surg Rehabil Original Manuscript INTRODUCTION: Surgical site infection (SSI) following fragility hip fracture (FHF) surgery is associated with increased morbidity and mortality. SIGNIFICANCE: Prediction of patients at risk for SSI is fundamental. We aimed to determine whether subcutaneous radiographic fat measurement (SRM) is associated with increased SSI risk. METHODS: A retrospective case-control comparison of SRMs at 3 locations around the hip. Patients diagnosed with SSI in the first post-operative year were matched with age, gender, surgical year, Charlsons’ co-morbidity index score, and surgical type controls, not diagnosed with SSI, at a 1:2 ratio. Measurements included the distance between (1) the sourcil to skin surface (SS), (2) the tip of the greater trochanter to skin surface (TGTS), and (3) the most prominent lateral aspect of the greater trochanter to skin surface. RESULTS: 1430 patients were operated during the study period, of whom 45 patients presented with a diagnosis of SSI and compared to 90 controls. Infections occurred 27.4 ( ± 24.8) days following surgery. SRM significantly differed between groups, and all were higher in the study group; SS, 86.8 ± 25.5 cm vs 74.2 ± 15.3 cm; TGTS, 59.8 ± 26.3 cm vs 47.0 ± 15.8 cm; and LGTS, 45.4 ± 25.1 cm vs 33.2 ± 15.1 cm (P = .003, .004, and .004, respectively). Intraclass correlation coefficients (intra-rater) were high for all measurements (.999 for all). Intraclass correlation coefficients (inter-rater) for SS, TGTS and LGTS were high, .749 (.663.815), .792 (.719.847) and .817 (.751.866), respectively. CONCLUSIONS: SRMs were found to be a valid and reproducible tool for predicting high risk of SSI in geriatric patients sustaining FHFs. LEVEL OF EVIDENCE: III. SAGE Publications 2022-02-23 /pmc/articles/PMC8874187/ /pubmed/35223132 http://dx.doi.org/10.1177/21514593221080272 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Manuscript
Frenkel Rutenberg, Tal
Markman, Rotem
Rutenberg, Ran
Daglan, Efrat
Rubin, Tomer
Shemesh, Shai
Thickness of the Subcutaneous Fat as a Risk Factor for Surgical Site Infection Following Fragility Hip Fracture Surgery
title Thickness of the Subcutaneous Fat as a Risk Factor for Surgical Site Infection Following Fragility Hip Fracture Surgery
title_full Thickness of the Subcutaneous Fat as a Risk Factor for Surgical Site Infection Following Fragility Hip Fracture Surgery
title_fullStr Thickness of the Subcutaneous Fat as a Risk Factor for Surgical Site Infection Following Fragility Hip Fracture Surgery
title_full_unstemmed Thickness of the Subcutaneous Fat as a Risk Factor for Surgical Site Infection Following Fragility Hip Fracture Surgery
title_short Thickness of the Subcutaneous Fat as a Risk Factor for Surgical Site Infection Following Fragility Hip Fracture Surgery
title_sort thickness of the subcutaneous fat as a risk factor for surgical site infection following fragility hip fracture surgery
topic Original Manuscript
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8874187/
https://www.ncbi.nlm.nih.gov/pubmed/35223132
http://dx.doi.org/10.1177/21514593221080272
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