PDF(Pubmed)
Abstract：
Pelvic ring fractures requiring surgical stabilization are severe injuries. Surgical site infections occurring after stabilization of the pelvis are serious complications, requiring complex and multidisciplinary treatment.
This is a retrospective observational study from a level I trauma centre. One hundred and ninety-two patients who underwent stabilization of closed pelvic ring injuries without signs of pathological fracture were selected for inclusion into the study. After excluding seven patients for having incomplete data, the final study group consisted of 185 patients (117 men and 68 women). Basic epidemiologic data and potential risk factors were recorded and analyzed by Cox regression, Kaplan-Meier curves, and risk ratios in 2 × 2 tables. Categorical variables were compared by Fisher exact tests and chi squared tests. Parametric variables were analyzed with Kruskal-Wallis tests with post hoc Wilcoxon tests.
Surgical site infections occurred in 13% of the study group (24 from 185). Eighteen infections occurred in men (15.4%) and six in women (8.8%). There were two significant risk factors in women: age over 50 years (p = 0.0232) and concomitant urogenital trauma (p = 0.0104). The common risk ratio for both these factors was 212.59 (8.78-5148.68), p = 0.0010. No significant risk factors were identified in men despite younger men having a higher incidence of infection (p = 0.1428).
Overall rate of infectious complications was higher than in the literature, but this might be caused by inclusion of all patients regardless of surgical strategy. Higher age in women and lower age in men were associated with higher infection rates. Concomitant urogenital trauma was a significant risk factor in women.
This is a retrospective observational study from a level I trauma centre. One hundred and ninety-two patients who underwent stabilization of closed pelvic ring injuries without signs of pathological fracture were selected for inclusion into the study. After excluding seven patients for having incomplete data, the final study group consisted of 185 patients (117 men and 68 women). Basic epidemiologic data and potential risk factors were recorded and analyzed by Cox regression, Kaplan-Meier curves, and risk ratios in 2 × 2 tables. Categorical variables were compared by Fisher exact tests and chi squared tests. Parametric variables were analyzed with Kruskal-Wallis tests with post hoc Wilcoxon tests.
Surgical site infections occurred in 13% of the study group (24 from 185). Eighteen infections occurred in men (15.4%) and six in women (8.8%). There were two significant risk factors in women: age over 50 years (p = 0.0232) and concomitant urogenital trauma (p = 0.0104). The common risk ratio for both these factors was 212.59 (8.78-5148.68), p = 0.0010. No significant risk factors were identified in men despite younger men having a higher incidence of infection (p = 0.1428).
Overall rate of infectious complications was higher than in the literature, but this might be caused by inclusion of all patients regardless of surgical strategy. Higher age in women and lower age in men were associated with higher infection rates. Concomitant urogenital trauma was a significant risk factor in women.
摘要：
目的：需要手术稳定的骨盆环骨折是严重的损伤。骨盆稳定后发生的手术部位感染是严重的并发症，需要复杂和多学科的治疗。
方法：这是一项来自I级创伤中心的回顾性观察性研究。选择了192例闭合性骨盆环损伤稳定而没有病理性骨折迹象的患者纳入研究。在排除了7名数据不完整的患者后，最终研究组包括185例患者(男117例,女68例).记录基本流行病学数据和潜在危险因素，并通过Cox回归分析。卡普兰-迈耶曲线,和2×2表中的风险比。通过Fisher精确检验和卡方检验比较分类变量。参数变量用Kruskal-Wallis检验和事后Wilcoxon检验进行分析。
结果：手术部位感染发生在研究组的13%（185名患者中有24名）。男性感染18例（15.4%），女性感染6例（8.8%）。女性有两个重要的危险因素：年龄超过50岁（p=0.0232）和伴随的泌尿生殖器创伤（p=0.0104）。这两个因素的共同风险比为212.59(8.78-5148.68)，p=0.0010。尽管年轻男性的感染率较高（p=0.1428），但在男性中未发现明显的危险因素。
结论：感染并发症的总发生率高于文献，但这可能是由于纳入所有患者而导致的，无论手术策略如何。女性年龄较高和男性年龄较低与感染率较高有关。伴随的泌尿生殖器创伤是女性的重要危险因素。
方法：这是一项来自I级创伤中心的回顾性观察性研究。选择了192例闭合性骨盆环损伤稳定而没有病理性骨折迹象的患者纳入研究。在排除了7名数据不完整的患者后，最终研究组包括185例患者(男117例,女68例).记录基本流行病学数据和潜在危险因素，并通过Cox回归分析。卡普兰-迈耶曲线,和2×2表中的风险比。通过Fisher精确检验和卡方检验比较分类变量。参数变量用Kruskal-Wallis检验和事后Wilcoxon检验进行分析。
结果：手术部位感染发生在研究组的13%（185名患者中有24名）。男性感染18例（15.4%），女性感染6例（8.8%）。女性有两个重要的危险因素：年龄超过50岁（p=0.0232）和伴随的泌尿生殖器创伤（p=0.0104）。这两个因素的共同风险比为212.59(8.78-5148.68)，p=0.0010。尽管年轻男性的感染率较高（p=0.1428），但在男性中未发现明显的危险因素。
结论：感染并发症的总发生率高于文献，但这可能是由于纳入所有患者而导致的，无论手术策略如何。女性年龄较高和男性年龄较低与感染率较高有关。伴随的泌尿生殖器创伤是女性的重要危险因素。
