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Information Journal Paper

Title

Implant Removal Due to Infection After Open Reduction and Internal Fixation: Trends and Predictors

Pages

  514-524

Abstract

 Background: Implant removal due to infection is one of the major causes failure following open reduction and internal fixation (ORIF). The aim of this study was to determine trends and predictors of infection-related implant removal following ORIF of extremities using a nationally representative database. Methods: Nationwide Inpatient Sample data from 2006 to 2017 was used to identify cases of ORIF following upper and lower extremity fractures, as well as cases that underwent infection-related implant removal following ORIF. Multivariate analysis was performed to identify independent predictors of infection-related implant removal, controlling for patient demographics and comorbidities, hospital characteristics, site of fracture, and year. Results: For all ORIF procedures, the highest rate of implant removal due to infection was the phalanges/hand (5. 61%), phalanges/foot (5. 08%), and the radius/ulna (4. 85%). Implant removal rates due to infection decreased in all fractures except radial/ulnar fractures. Tarsal/metatarsal fractures (odds ratio (OR)=1. 45, 95% confidence interval (CI): 1. 02-2. 05), and tibial fractures (OR=1. 82, 95% CI: 1. 45-2. 28) were identified as independent predictors of infection-related implant removal. Male gender (OR=1. 67, 95% CI: 1. 49-1. 87), Obesity (OR=1. 85, 95% CI: 1. 34-2. 54), diabetes mellitus with chronic complications (OR=1. 69, 95% CI: 1. 13-2. 54, P<0. 05), deficiency anemia (OR=1. 59, 95% CI: 1. 14-2. 22) were patient factors that were associated with increased infection-related removals. Removal of implant due to infection had a higher total charge associated with the episode of care (mean: $166, 041) than non-infection related implant removal (mean: $133, 110). Conclusion: Implant removal rates due to infection decreased in all fractures except radial/ulnar fractures. Diabetes, liver disease, and rheumatoid arthritis were important predictors of infection-related implant removal. The study identified some risk factors for implant related infection following ORIF, such as diabetes, obesity, and anemia, that should be studied further to implement strategies to reduce rate of infection following ORIF.

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    APA: Copy

    Kellish, Alec S., Shahi, Alisina, Rodriguez J.r., Julio A., Usmani, Kudret, Boniello, Michael, Oliashirazi, Ali, Graf, Kenneth, Dolch, Henry, Fuller, David, & Mashru, Rakesh P.. (2022). Implant Removal Due to Infection After Open Reduction and Internal Fixation: Trends and Predictors. THE ARCHIVES OF BONE AND JOINT SURGERY, 10(6), 514-524. SID. https://sid.ir/paper/1086096/en

    Vancouver: Copy

    Kellish Alec S., Shahi Alisina, Rodriguez J.r. Julio A., Usmani Kudret, Boniello Michael, Oliashirazi Ali, Graf Kenneth, Dolch Henry, Fuller David, Mashru Rakesh P.. Implant Removal Due to Infection After Open Reduction and Internal Fixation: Trends and Predictors. THE ARCHIVES OF BONE AND JOINT SURGERY[Internet]. 2022;10(6):514-524. Available from: https://sid.ir/paper/1086096/en

    IEEE: Copy

    Alec S. Kellish, Alisina Shahi, Julio A. Rodriguez J.r., Kudret Usmani, Michael Boniello, Ali Oliashirazi, Kenneth Graf, Henry Dolch, David Fuller, and Rakesh P. Mashru, “Implant Removal Due to Infection After Open Reduction and Internal Fixation: Trends and Predictors,” THE ARCHIVES OF BONE AND JOINT SURGERY, vol. 10, no. 6, pp. 514–524, 2022, [Online]. Available: https://sid.ir/paper/1086096/en

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