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

被引:3
作者
Chebli, Djenna [1 ]
Dhaif, Fatema [2 ,3 ]
Ridha, Ali [2 ,3 ]
Schade, Alexander [4 ]
Khatri, Chetan [2 ,3 ,5 ]
机构
[1] Univ Warwick, Warwick Med Sch, Coventry, England
[2] Univ Warwick, Warwick Clin Trials Unit, Warwick Orthopaed Special Training Rotat, Coventry, England
[3] Univ Hosp Coventry & Warwickshire, Dept Trauma & Orthopaed, Coventry, England
[4] Malawi Liverpool Wellcome Trust, Blantyre, Malawi
[5] Warwick Med Sch, Warwick Orthopaed Special Training Rotat, Coventry, England
关键词
Infection; open tibia fractures; trauma; INTRAMEDULLARY NAIL; EXTERNAL FIXATION; RANDOMIZED-TRIAL; EPIDEMIOLOGY; MANAGEMENT; BURDEN; UGANDA;
D O I
10.1177/00494755241232171
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
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.
引用
收藏
页码:272 / 281
页数:10
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