Comparative accuracy assessment of the Gustilo and Tscherne classification systems as predictors of infection in open fractures

Abstract

ObjectiveThe aim of this study is to analyze the accuracy of the two classification systems for open fractures most commonly used in current medical practice, Gustilo and Tscherne, as predictors of infection. MethodsA retrospective observational study was performed, including 121 patients suffering from open fracture of the appendicular skeleton treated at an emergency hospital. The fractures were classified according to Gustilo and Tscherne systems during the initial treatment, and ratings were subsequently confirmed or rectified during hospitalization. Sensitivity, specificity, positive and negative predictive values, and accuracy were calculated according to each classification adopted. ResultsThe results of this study demonstrated that both classifications of Gustilo and Tscherne are associated with the clinical outcome of infection in open fractures. The Gustilo classification achieved sensitivity of 76.7%, specificity of 53.8%, and accuracy of 59.5%. Tscherne's classification had a sensitivity of 56.7%, specificity 82.4%, and accuracy of 76.1%. ConclusionThe Tscherne system showed better accuracy, including specificity as a predictor of infection in open fractures, when compared with the Gustilo system.