Incidence and Predictors of Surgical Site Infection Complications in Diabetic Patients Undergoing Lower Limb Amputation

Chahrour, Mohamad; Moheb, Mohamad El; Cherfan, Patrick; Mahmoud, Dima; Rahyel, Ahmed El; Khachfe, Hussein H.; Hoballah, Jamal J.

doi:10.1016/j.avsg.2021.09.040

Cited by 6 publications

(12 citation statements)

References 31 publications

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“…A growing number of studies have identified obesity and high BMI as risk factors for SSI, 26 , 27 , 28 , 29 , 30 which is consistent with the findings of this study. Findings from published systematic reviews indicate that BMI‐defined obesity is established as astatistically significant factor for spinal SSI.…”

Section: Discussionsupporting

confidence: 92%

Risk factors for surgical site infection after closed proximal humerus fractures

Li,

Sun,

Cui

et al. 2023

International Wound Journal

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Proximal humerus fractures are common in clinical practice, and there are relatively a few studies on postoperative incision infections of such fractures. The purpose of this study was to explore the risk factors for surgical site infection (SSI) after internal fixation in patients with closed proximal humerus fractures. Patients with closed proximal humerus fractures who underwent surgery from January 2016 to January 2022 were retrospectively analysed. Cases with superficial or deep infections within 3 months after surgery were in the infection group and the remaining cases were in the non‐infection group. The types of pathogenic bacteria in the infection group were analysed. The potential risk factors for SSI in all patients were recorded: (1) patient‐related factors: gender, age, body mass index (BMI), smoking, comorbidities; (2) trauma‐related factors: mechanism of injury, Injury Severity Score, visual analogue scale, fracture type, soft tissue condition and combined dislocation; (3) laboratory‐related indexes: haemoglobin, albumin; (4) surgery‐related factors: time from injury to surgery, American Society of Anesthesiologists anaesthesia classification, surgical time, fixation mode, intraoperative blood loss, suture method, bone graft and postoperative drainage. The risk factors for the occurrence of SSI were analysed using univariate analysis and multivariate logistic regression. The incidence of SSI was 15.7%. The most common bacterium in the infection group was Staphylococcus aureus. High BMI (p = 0.033), smoking (p = 0.030), an increase in mean time from injury to definitive surgery (p = 0.013), and prolonged surgical time (p = 0.044) were independent risk factors for the development of SSI after closed proximal humeral fractures. In patients with closed proximal humerus fractures, weight loss, perioperative smoking cessation, avoidance of delayed surgery, and shorter surgical time may be beneficial in reducing the incidence of SSI.

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Section: Discussionsupporting

confidence: 92%

Risk factors for surgical site infection after closed proximal humerus fractures

Li,

Sun,

Cui

et al. 2023

International Wound Journal

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“…Sex differences have been described previously in regard to incidence rates and short- and long-term outcomes after LEAs among people with T2DM [ 2 , 3 , 6 , 7 , 8 , 9 ]. Several studies suggest that men have higher incidence rates than women [ 2 , 3 , 6 , 7 , 8 ], but being a woman is associated with more frequent surgical site infections and a higher risk of dying in the hospital following LEAs [ 3 , 9 ].…”

Section: Introductionmentioning

confidence: 90%

Trends of Non-Traumatic Lower-Extremity Amputation and Type 2 Diabetes: Spain, 2001–2019

López‐de‐Andrés

Jiménez‐García

Hernández‐Barrera

et al. 2022

JCM

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(1) Background: To examine trends in the incidence (2001–2019), clinical characteristics and in-hospital outcomes following major and minor non-traumatic lower-extremity amputations (LEAs) among people with type 2 diabetes mellitus (T2DM) in Spain, assessing possible sex differences. (2) Methods: Retrospective cohort study using data from the Spanish National Hospital Discharge Database. Joinpoint regression was used to estimate incidence trends, and multivariable logistic regression to estimate factors associated with in-hospital mortality (IHM). (3) Results: LEA was coded in 129,059 patients with T2DM (27.16% in women). Minor LEAs accounted for 59.72% of amputations, and major LEAs comprised 40.28%. The adjusted incidences of minor and major LEAs were higher in men than in women (IRR 3.51; 95%CI 3.46–3.57 and IRR 1.98; 95%CI 1.94–2.01, respectively). In women, joinpoint regression showed that age-adjusted incidence of minor LEAs remained stable over time, and for major LEAs, it decreased from 2006 to 2019. In men, incidences of minor and major LEAs decreased significantly from 2004 to 2019. In-hospital mortality (IHM) increased with age and the presence of comorbidity, such as heart failure (OR 5.11; 95%CI 4.61–5.68, for minor LEAs and OR 2.91; 95%CI 2.71–3.13 for major LEAs). Being a woman was associated with higher IHM after minor and major LEA (OR 1.3; 95%CI 1.17–1.44 and OR 1.18; 95%CI 1.11–1.26, respectively). (4) Conclusions: Our data showed major sex differences indicating decreasing and increasing LEA trends among men and women, respectively; furthermore, women presented significantly higher IHM after minor and major LEA procedures than men.

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“…24 Additionally, surgical procedures often associated with this patient group increase the risk of surgical site infections (SSI). 25 Current evidence suggests that infections from bacteria, fungi, and viruses can lead to vascular wall inflammation and progression towards peripheral arterial disease by direct contamination, increased systemic immune reactions, or a combination of both mechanisms. 26 One of the most severe clinical manifestations caused by secondary infections in DFU is sepsis and its progression to organ failure.…”

Section: Discussionmentioning

confidence: 99%

Type 2 Diabetes Mellitus Status with Ankle-Brachial Index among Patients with Diabetic Foot Ulcer at Universitas Airlangga Hospital, Surabaya

Anisah,

Limanto,

Suryantoro

et al. 2024

JUXTA

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Highlights: ABI was not influenced by diabetic status. A more severe form of diabetic ulcer was associated with a lower ABI value. Abstract Introduction: Diabetic foot ulcer (DFU) is one of the most significant complications of uncontrolled type 2 diabetes mellitus (T2DM) that may affect a patient’s prognosis and quality of life. This study aimed to identify the association between diabetic status, DFU severity, and other clinical factors with ankle-brachial index (ABI) score and category. Methods: This was a cross-sectional study under a consecutive sampling frame conducted for three months at Universitas Airlangga Hospital, Surabaya. Primary data for ABl were measured from T2DM patients with DFU in the Thoracic and Cardiovascular Polyclinic, while secondary clinical data were collected from the Department of Internal Medicine based on the inclusion and exclusion criteria specified in the patient's medical records. Results: Out of 30 included patients, 63.33% had uncontrolled diabetic status, and the average ABI score was 0.999 ± 0.19. DFU severity was significantly associated with the ABI score and ABI category. Patients indicated with angioplasty exhibited a markedly lower ABI score than those without (mean 0.32 vs 1.01; p < 0.001). Indication of angioplasty was the only clinical factor significantly associated with a lower ABI score (p < 0.001). Conclusion: Although the status of T2DM was unrelated to ABI, future research is recommended to advance the understanding of peripheral artery disease in diabetic foot ulcer patients.

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Incidence and Predictors of Surgical Site Infection Complications in Diabetic Patients Undergoing Lower Limb Amputation

Cited by 6 publications

References 31 publications

Risk factors for surgical site infection after closed proximal humerus fractures

Risk factors for surgical site infection after closed proximal humerus fractures

Trends of Non-Traumatic Lower-Extremity Amputation and Type 2 Diabetes: Spain, 2001–2019

Type 2 Diabetes Mellitus Status with Ankle-Brachial Index among Patients with Diabetic Foot Ulcer at Universitas Airlangga Hospital, Surabaya

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