학술논문
A meta-analysis of the incidence of infections following open tibia fractures and the microorganisms that cause them in high-, middle- and low-income countries.
Document Type
Academic Journal
Author
Chebli D; Medical Student, Warwick Medical School, University of Warwick, Coventry, UK.; Dhaif F; Specialist Registrar, Warwick Orthopaedic Speciality Training Rotation, Warwick Clinical Trials Unit, University of Warwick, Coventry, UK.; Academic Foundation Doctor, Department of Trauma & Orthopaedics, University Hospitals Coventry and Warwickshire, Coventry, UK.; Ridha A; Specialist Registrar, Warwick Orthopaedic Speciality Training Rotation, Warwick Clinical Trials Unit, University of Warwick, Coventry, UK.; Academic Foundation Doctor, Department of Trauma & Orthopaedics, University Hospitals Coventry and Warwickshire, Coventry, UK.; Schade A; Wellcome Trust PhD Fellow, Malawi-Liverpool-Wellcome Trust, Blantyre, Malawi.; Khatri C; Specialist Registrar, Warwick Orthopaedic Speciality Training Rotation, Warwick Clinical Trials Unit, University of Warwick, Coventry, UK.; Academic Foundation Doctor, Department of Trauma & Orthopaedics, University Hospitals Coventry and Warwickshire, Coventry, UK.
Source
Publisher: Sage Country of Publication: England NLM ID: 1301706 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1758-1133 (Electronic) Linking ISSN: 00494755 NLM ISO Abbreviation: Trop Doct Subsets: MEDLINE
Subject
Language
English
Abstract
Open tibia fractures are devastating, life changing injuries, with infection associated with substantial morbidity to the patient. Reducing infection is a research priority, but before interventional studies can be designed, the incidence of infection following this injury needs to be better defined. Our aim was to estimate the global incidence of infection following an open tibia fracture. A systematic review was performed of MEDLINE, EMBASE, Central Register of Controlled Trials (CENTRAL), Web of Science and Global Index Medicus. We included randomised controlled trials with more than ten participants which reported infections after open diaphyseal or distal fractures (AO 42 or 43). Primary outcome was deep infection according to the Centres for Disease Control and Prevention criteria. Secondary outcome included causative micro-organisms. A meta-analysis using a random effects model to assess incidence and between-treatment effects was performed. Thirteen studies including 1463 adults from seven middle-income countries, seven high-income countries and one low-income country were included. The incidence of infection was 12.12 person-years (95% CI 7.95-18.47). A subgroup analysis compared external fixation and intramedullary nailing showed no difference between infection rates. There were limited data on organisms, but Staphylococcus aureus was the most commonly identified. There are limited to no data on antimicrobial resistance.
Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.