The Impact of Fracture-Related Infection on Quality of Life and Complications

Abstract

Abstract

BACKGROUND By gaining insight into the Quality of Life (QoL) and occurrence of complications, critical facets in the care for patients with Fracture-Related Infection (FRI) can be mitigated. Therefore, the aims of this study were to 1) determine the QoL in FRI patients in comparison to non-FRI patients and 2) describe the incidence of complications in this cohort.

METHODS An ambidirectional cohort study was conducted in a level 1 trauma centre between January 1st 2016 and November 1st 2021. All patients who underwent surgical stabilisation of an isolated long bone fracture were eligible for inclusion. Patients with an injury severity score ≥16 or incomplete follow-up were excluded. QoL was assessed through the use of five-level EuroQol five-dimension questionnaires twelve months post-injury.

RESULTS A total of 134 patients were included, of whom 38 (28%) FRI patients and 96 (72%) non-FRI patients. FRI patients scored significantly worse on the QoL assessment regarding the average index (p=0.007), and the subjects’ mobility (p=0.00), daily activities (p=0.010) and pain (p=0.009). During the median follow-up of 14.5 months (interquartile range 9.5-26.5), patients developed other complications besides FRI in 42% (n=56) of cases. A higher complication rate was reported in FRI patients (74%), compared to non-FRI patients (29%), with a total of 56 and 36 individual complications, respectively.

CONCLUSION FRI patients have a decreased QoL and a higher overall complication rate (74%) in comparison to non-FRI patients (29%). As a result of this study, FRI patients can be better counselled regarding the potential physical and mental consequences of their disease.