PD02-06 RISK OF INFECTIOUS COMPLICATIONS IN PATIENTS WITH TRAUMATIC URETHRAL INJURIES UNDERGOING INTERNAL FIXATION OF PELVIC FRACTURES AND SUPRAPUBIC TUBE PLACEMENT: A NATIONAL TRAUMA DATA BANK ANALYSIS

Abstract

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: External Genitalia Reconstruction and Urotrauma (including transgender surgery) I1 Apr 2018PD02-06 RISK OF INFECTIOUS COMPLICATIONS IN PATIENTS WITH TRAUMATIC URETHRAL INJURIES UNDERGOING INTERNAL FIXATION OF PELVIC FRACTURES AND SUPRAPUBIC TUBE PLACEMENT: A NATIONAL TRAUMA DATA BANK ANALYSIS Niels Johnsen and Bryan Voelzke Niels JohnsenNiels Johnsen More articles by this author and Bryan VoelzkeBryan Voelzke More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.231AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Despite guideline statements that suprapubic tube (SPT) placement is safe in pelvic fracture urethral injury (PFUI) patients undergoing internal fixation (IF) of pelvic fractures, there is a paucity of data evaluating this question and significant disagreement between urologist and orthopedists. Utilizing the National Trauma Data Bank (NTDB), we sought to examine if placement of a SPT in patients with traumatic urethral injuries undergoing IF of pelvic fractures increases the risks of infectious complications during the index hospitalization. METHODS Utilizing ICD-9 and AIS codes, patients with PFUI were identified in the NTDB between 2002 and 2014. ICD-9 codes were used to identify patients who underwent IF of pelvic fractures as well as those who underwent SPT placement. Covariates analyzed included age, sex, injury severity score (ISS), diabetes, hypertension, coronary artery disease, obesity, smoking status, associated colorectal injuries, and pelvic angioembolization. Demographics, management and infectious complications (inclusive of surgical site infection, sepsis, or urinary tract infection) between IF patients who did or did not undergo SPT placement were compared using chi-square and t-tests. Poisson regression analysis was performed to identify predictors of infectious complications. RESULTS 696 PFUI patients were identified. 204 patients (29.3%) underwent IF during the index hospitalization, of which 35 (33.0%) also underwent SPT placement. There was no difference in likelihood of undergoing IF in patients with or without SPT (p=0.36). On univariate analysis, ISS (p=0.01) and smoking status (p=0.04) were associated with an increased risk of infectious complications during the index hospitalization in IF patients, while SPT placement was not (p=0.79) Multivariate analysis similarly revealed that only ISS (RR 4.00, 95% CI 1.25, 12.77) and smoking status (RR 2.45, 95% CI 1.11, 5.43) were significant predictors of infection. CONCLUSIONS Among patients with PFUI undergoing IF, placement of a SPT does not appear to increase the risk for acute infectious complications during index hospitalization, while higher ISS and smoking are significantly associated. Although this study is limited by lack of information regarding temporality of treatments and follow-up after index discharge, these findings provide data to aid in addressing this controversial clinical question. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e67 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Niels Johnsen More articles by this author Bryan Voelzke More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...