The following is a summary of “Surgical site infection in severe trauma patients in intensive care: epidemiology and risk factors,” published in the September 2024 issue of Critical Care by Savio et al.

Surgical site infections (SSI) are defined as a significant complication in the severe trauma population, inducing disability and mortality in patients under 35 years of age. 

Researchers conducted a retrospective study to investigate the epidemiology of SSI and risk factors in severe trauma patients (STP).

They performed a retrospective cohort study involving screening patients with severe trauma admitted to 2 intensive care units at an academic institution in Marseille between 2018 and 2019; it included patients who had undergone orthopedic or spinal surgery within 5 days of admission and categorized them into 2 groups based on whether they developed SSI, as defined by the Centers for Disease Control (CDC) international diagnostic criteria. The secondary goals were to evaluate STP survival at 48 months, determine risk factors for SSI, and examine the microbiological characteristics of SSI.

The results showed that 47 STPs (23%) developed SSI. Mortality at 48 months did not vary between patients with and without SSI (12.7% vs. 10.0%; P = 0.59). Among 22 patients with SSI, (47%) had fractures classified as Cauchoix 3 grade, and 18 (38%) required external fixators. About 30 patients (64%) with SSI had polymicrobial infections, with 34 (72%) induced by Gram-positive cocci. Antibiotic therapy confirmed effectiveness in 31 cases (66%). The multivariate analysis determined risk factors for SSI in STP, such as low hemoglobin, arterial oxygenation levels, hyperlactatemia, high serum creatinine, glycemia, and Cauchoix 3 grade on the day of surgery. The predictive model indicated good performance, with an AUC of 0.80 [0.73–0.88] and a high negative predictive value of 95.9% [88.6–98.5].

They concluded a high rate of SSI in STP, but SSI was not linked with 48-month mortality. 

Source: annalsofintensivecare.springeropen.com/articles/10.1186/s13613-024-01370-7#Abs1