[Ortho] Идет конгресс Orthopaedic Trauma Association

[xudobin на mail.ru]

Ув.  Александр  Николаевич.  Очень  интересная  картина получается. По
данным,  приведенным  в  ссылке  доктора  Середы  мочевая  инфекция на
инфицирование   после   операции  на  проксимальном  отделе  бедра  не
влияет(по  крайней мере так как другие факторы). По данным приведенным
в  вашей  ссылке  наоборот существенно влияет. А показатель отдалённой
смертности   -  наоборот.  Дискуссия  не  аактуальна  поскольку  любая
инфекция,  выявленная  перед  операцией  влияет  на исход операции, но
понять    почему   такие   разночтения(всё-таки   не   наши   снгешные
исследователи) хотелось бы.

Monday, October 8, 2012, 9:38:59 PM, you wrote:

> Яуже дома посмотрю, может, я эту преентацию сфотографировал. Пока можно в тезисах посмотреть.
> Postoperative Urinary Tract Infection Results in Higher Rates of
> Deep Infection in Patients With Proximal Femoral Fractures

> Benjamin J. Ollivere, FRCS, MBBS, MD; Thomas Kurien, MBBS; Claire Morris, MA;
> Daren P. Forward, FRCS; Christopher G. Moran, MD, FRCS;
> Queens Medical Centre, Nottingham, United Kingdom

> Purpose: Patients presenting with a fractured neck of femur are a
> fragile group with multiple comorbidities who are at risk of
> postoperative complications. As many as 52% of patients are reported
> to suffer a urinary tract infection (UTI) after hip fracture
> surgery. As there are little data surrounding the effects of
> postoperative UTIs on mortality and deep prosthetic infection, we
> aim to investigate the effects of a perioperative UTI.

> Methods: We prospectively investigated the impact of postoperative
> UTI in 9168 patients admitted to our institution with a diagnosis of
> proximal femoral fracture over an 11-year period in a prospective
> population study. We examined the effects of postoperative UTI on
> the incidence of deep infection, survivorship, and length of stay.

> Results: Postoperative UTI occurred in 6.1% (n = 561) and deep
> infection in 0.89% (n = 82). Deep infection was significantly more
> common in patients complicated with a UTI (3.2% vs 0.74%, P <0.001)
> with a relative risk of 3.7:1. In 58% of patients the same organism
> was cultured in the urine and hip samples. A postoperative UTI did
> not adversely affect 90-day survival; however, it was associated
> with an increased length of stay (receiver operating curve [ROC]
> analysis, area under the curve [AUC] = 0.79). Delays to surgery and
> age were not predictive of a postoperative UTI.

> Conclusion: Recognition of the risks posed by postoperative UTI and
> the risk factors for development of infection, and early treatment
> are essential to reduce the risks of increased subsequent periprosthetic infection.
> Alexander Chelnokov


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 Xudobin                            mailto:xudobin на mail.ru