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What Are the Risk Factors for Surgical Site Infection in HIV-Positive Patients Receiving Open Reduction and Internal Fixation of Traumatic Limb Fractures? A Retrospective Cohort Study
AIDS Research and Human Retroviruses ( IF 1.5 ) Pub Date : 2021-07-01 , DOI: 10.1089/aid.2020.0184
Rugang Zhao 1, 2 , Rui Ding 3 , Qiang Zhang 1
Affiliation  

A lack of studies analyze risk factors associated with surgical site infection (SSI) in human immunodeficiency virus (HIV)-positive patients with trauma undergoing orthopedic surgery. We questioned, (1) “What is the proportion of SSI in HIV-positive patients receiving open reduction and internal fixation (ORIF) of traumatic limb fractures?” and (2) ”What are the independent risk factors for SSI of HIV-positive patients with traumatic limb fractures who received ORIF?” A retrospective study was performed in our institution from May 2011 to December 2019. A total of 246 patients were enrolled. Data of HIV-positive adult patients with traumatic limb fractures treated by ORIF were extracted from the electronic medical records, including the demographic information, characteristics of fractures, treatment-related variables, and indexes of laboratory examination. Multivariable logistic regression was used to identify independent predictors of SSI. A total of 26 patients developed SSI in this study, the overall proportion was 10.6% [95% confidence interval (CI) = 7.2%–15.3%]. Among them, 18 cases (7.3%) suffered from superficial SSI and 8 cases (3.3%) had the deep SSI. Independent predictors of SSI identified by multivariable logistic regression analysis were CD4+ T-lymphocyte count (adjusted odds ratio per 100/μL increase = 0.55; 95% CI = 0.37–0.81; p = .002) and albumin (adjusted odds ratio per 5 g/liter increase = 0.50; 95% CI = 0.30–0.81; p = .003). We recommend that orthopedic surgeons assess immunosuppression and nutritional status of HIV-positive patients rigorously and optimize the perioperative strategy of supplementary to reduce the risk of SSI.

中文翻译:

外伤性四肢骨折切开复位内固定术的 HIV 阳性患者手术部位感染的危险因素是什么?一项回顾性队列研究

缺乏研究分析与人类免疫缺陷病毒 (HIV) 阳性的外伤患者进行整形外科手术的手术部位感染 (SSI) 相关的危险因素。我们质疑,(1)“在接受切开复位内固定(ORIF)的外伤性肢体骨折的 HIV 阳性患者中,SSI 的比例是多少?” (2) “接受 ORIF 治疗的 HIV 阳性创伤性肢体骨折患者 SSI 的独立危险因素是什么?” 2011 年 5 月至 2019 年 12 月在我们机构进行了一项回顾性研究。共招募了 246 名患者。从电子病历中提取经 ORIF 治疗的 HIV 阳性成人创伤性肢体骨折患者的数据,包括人口统计学信息、骨折特征、治疗相关变量、和实验室检查指标。多变量逻辑回归用于识别 SSI 的独立预测因子。本研究共有 26 名患者出现 SSI,总体比例为 10.6% [95% 置信区间 (CI) = 7.2%–15.3%]。其中浅表SSI 18例(7.3%),深部SSI 8例(3.3%)。通过多变量逻辑回归分析确定的 SSI 的独立预测因子是 CD4+ T 淋巴细胞计数(每增加 100 个调整后的优势比 = 0.55;95% CI = 0.37–0.81;p  = .002)和白蛋白(每增加 5 克/升调整后优势比 = 0.50;95% CI = 0.30 –0.81;p  = .003)。我们建议骨科医生严格评估 HIV 阳性患者的免疫抑制和营养状况,优化围手术期补充策略,降低 SSI 风险。
更新日期:2021-07-07
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