ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2026
Elevated risk of wound and systemic complications in MRSA-colonized patients undergoing lower extremity orthopedic trauma surgery.
Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposePreoperative colonization with methicillin-resistant Staphylococcus aureus (MRSA) is a known risk factor for adverse outcomes in arthroplasty but remains under-investigated in orthopedic trauma. This study evaluates the impact of preoperative MRSA colonization on postoperative complication rates in patients undergoing lower extremity orthopedic trauma surgery.
methodsWe conducted a retrospective cohort study using the TriNetX Research Network, identifying adult patients who underwent lower extremity orthopedic trauma procedures over a 20-year period. Patients with a documented MRSA diagnosis within three months before surgery were matched 1:1 to MRSA-negative controls based on demographics and comorbidities. Postoperative outcomes were assessed within three months of surgery, including surgical site infections (SSIs), wound dehiscence, organ dysfunction, thromboembolic events, and healthcare utilization. Odds ratios (ORs) and p-values were calculated, with statistical significance set at p < 0.05.
resultsA total of 1,868 MRSA+ and 629,342 control patients were identified. After matching, MRSA+ patients remained at significantly increased risk for wound dehiscence (OR = 1.80, p = 0.005), pneumonia (OR = 2.33, p < 0.001), sepsis (OR = 3.71, p < 0.001), acute renal failure (OR = 1.45, p < 0.001), blood transfusion (OR = 1.74, p < 0.001), deep vein thrombosis (OR = 2.29, p < 0.001), and pulmonary embolism (OR = 2.80, p < 0.001). No significant differences in SSIs were observed after matching.
conclusionPreoperative MRSA colonization is associated with increased risks of wound dehiscence, pneumonia, sepsis, thromboembolic events, blood transfusions, and acute renal failure in orthopedic trauma patients. Preoperative MRSA screening may serve as a risk-stratification tool, enabling surgeons to anticipate systemic complications and optimize management. Where feasible, screening with targeted decolonization or prophylactic strategies may mitigate risk.
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