Fracture-Related Infection After Internal Fixation of Pelvic and Acetabular Fractures: A Population-Based Analysis of Risk Factors and Economic Costs

Fracture-related infection (FRI) is a relatively common and severe complication following operatively managed fractures. Patients with pelvic and acetabular fractures (PAFs) are a high-risk patient group, represent high injury severity and are often polytraumatised. The aims of this study are to characterise a population-based cohort of patients with PAF complicated by FRI, to identify risk factors for FRI and estimate the health economic burden A retrospective analysis of a 10-year population-based, person-linked dataset including all PAF patients undergoing internal fixation within Queensland, Australia was performed. Demographic and clinical variables were collected and included into a multivariate logistic regression. Health economic variables were compared between infected and uninfected PAF patients. There were 842 patients sustaining PAF, of which 52 (6.4%) were complicated by FRI. Patients with open fractures, increased length of hospital stay, and rural location of residence were independently associated with the development of FRI. Direct inpatient costs for managing FRI were higher at $69,088 versus $40,904 for uninfected PAF management. The results of this study should be utilised to advocate for improvements in trauma care, inform clinicians on epidemiology of infection in PAF to aid management decisions, and to drive research and innovation to improve preventative and treatment strategies for FRI.