Evidence map›Paper›PMID 33339519›Full record

ArticleBMC musculoskeletal disorders2020

Surgical site infections after distal radius fracture surgery: a nation-wide cohort study of 31,807 adult patients.

Johanna Rundgren, Anders Enocson, Hans Järnbert-Pettersson, Cecilia Mellstrand Navarro

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC musculoskeletal disorders, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 2 pooled it
2.2field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 16 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Johanna RundgrenDepartment of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, SE-118 83, Stockholm, Sweden. johanna.rundgren@sll.se.ORCID http://orcid.org/0000-0003-4680-4963
Anders EnocsonDepartment of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, SE-118 83, Stockholm, Sweden.
Hans Järnbert-PetterssonDepartment of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, SE-118 83, Stockholm, Sweden.
Cecilia Mellstrand NavarroDepartment of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, SE-118 83, Stockholm, Sweden.
Karolinska Institutet · SE

Funding

Stockholms Läns Landsting 20140095
6 · The paper itself

Abstract

backgroundSurgical site infections (SSI) after distal radius fracture (DRF) surgery have not previously been studied as the primary outcome in a large population with comparative data for different surgical methods. The aims of this study were 1) to compare SSI rates between plate fixation, percutaneous pinning and external fixation, and 2) to study factors associated with SSI.

methodsWe performed a nation-wide cohort study linking data from the Swedish national patient register (NPR) with the Swedish prescribed drug register (SPDR). We included all patients ≥18 years with a registration of a surgically treated DRF in the NPR between 2006 and 2013. The primary outcome was a registration in the SPDR of a dispensed prescription of peroral Flucloxacillin and/or Clindamycin within the first 8 weeks following surgery, which was used as a proxy for an SSI. The SSI rates for the three main surgical methods were calculated. Logistic regression was used to study the association between surgical method and the primary outcome, adjusted for potential confounders including age, sex, fracture type (closed/open), and a dispensed prescription of Flucloxacillin and/or Clindamycin 0-8 weeks prior to DRF surgery. A classification tree analysis was performed to study which factors were associated with SSI.

resultsA total of 31,807 patients with a surgically treated DRF were included. The proportion of patients with an SSI was 5% (n = 1110/21,348) among patients treated with plate fixation, 12% (n = 754/6198) among patients treated with percutaneous pinning, and 28% (n = 1180/4261) among patients treated with external fixation. After adjustment for potential confounders, the surgical method most strongly associated with SSI was external fixation (aOR 6.9 (95% CI 6.2-7.5, p < 0.001)), followed by percutaneous pinning (aOR 2.7 (95% CI 2.4-3.0, p < 0.001)) (reference: plate fixation). The classification tree analysis showed that surgical method, fracture type (closed/open), age and sex were factors associated with SSI.

conclusionsThe SSI rate was highest after external fixation and lowest after plate fixation. The results may be useful for estimation of SSI burdens after DRF surgery on a population basis. For the physician, they may be useful for  estimating the likelihood of SSI in individual patients.

Indexed as

Radius FracturesSurgical Wound InfectionAdolescentAdultAgedBone PlatesCohort StudiesFemaleFracture FixationFracture Fixation, InternalHumansMaleMiddle AgedSwedenTreatment OutcomeYoung AdultAntibioticsComplicationsDistal radius fractureExternal fixationInfection after fracture fixationPercutaneous pinningPin fixationPlate fixationPostoperative infectionSurgical site infection

Identifiers

PMID33339519
PMCPMC7749509
OpenAlexW3117888952

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.