Are self-reported anthropometric data reliable enough to meet antibiotic prophylaxis guidelines in orthopedic surgery?


Journal

Orthopaedics & traumatology, surgery & research : OTSR
ISSN: 1877-0568
Titre abrégé: Orthop Traumatol Surg Res
Pays: France
ID NLM: 101494830

Informations de publication

Date de publication:
11 2023
Historique:
received: 16 12 2021
revised: 05 01 2023
accepted: 10 01 2023
medline: 6 11 2023
pubmed: 27 4 2023
entrez: 26 4 2023
Statut: ppublish

Résumé

Surgical site infection is a serious complication in orthopedic surgery. The use of antibiotic prophylaxis (AP) combined with other prevention strategies has been shown to reduce this risk to 1% for hip arthroplasty and 2% for knee arthroplasty. The French Society of Anesthesia and Intensive Care Medicine (SFAR) recommends doubling the dose when the patient's weight is greater than or equal to 100 kg, and the body mass index (BMI) is greater than or equal to 35 kg/m The hypothesis of our study was that self-reported anthropometric values differed from those measured during preoperative orthopedic consultations. This single-center retrospective study with prospective data collection was conducted between October and November 2018. The patient-reported anthropometric data were first collected and then directly measured by an orthopedic nurse. Weight was measured with a precision of 500 g and height was measured with a precision of 1 cm. A total of 370 patients (259 women and 111 men) with a median age of 67 years (17-90) were enrolled. The data analysis found significant differences between the self-reported and measured height [166 cm (147-191) vs. 164 cm (141-191) (p<0.0001)], weight [72.9 kg (38-149) vs. 73.1 kg (36-140) (p<0.0005)] and BMI [26.3 (16.2-46.4) vs. 27 (16-48.2) (p<0.0001)]. Of these patients, 119 (32%) reported an accurate height, 137 (37%) an accurate weight, and 54 (15%) an accurate BMI. None of the patients had two accurate measurements. The maximum underestimation was 18 kg for weight, 9 cm for height, and 6.15 kg/m Although patients underestimated their weight and overestimated their height in our study, these had no impact on the perioperative AP regimens. However, this misreporting failed to detect potential contraindications to surgery. IV; retrospective study with prospective data collection and no control group.

Sections du résumé

BACKGROUND
Surgical site infection is a serious complication in orthopedic surgery. The use of antibiotic prophylaxis (AP) combined with other prevention strategies has been shown to reduce this risk to 1% for hip arthroplasty and 2% for knee arthroplasty. The French Society of Anesthesia and Intensive Care Medicine (SFAR) recommends doubling the dose when the patient's weight is greater than or equal to 100 kg, and the body mass index (BMI) is greater than or equal to 35 kg/m
HYPOTHESIS
The hypothesis of our study was that self-reported anthropometric values differed from those measured during preoperative orthopedic consultations.
MATERIALS AND METHODS
This single-center retrospective study with prospective data collection was conducted between October and November 2018. The patient-reported anthropometric data were first collected and then directly measured by an orthopedic nurse. Weight was measured with a precision of 500 g and height was measured with a precision of 1 cm.
RESULTS
A total of 370 patients (259 women and 111 men) with a median age of 67 years (17-90) were enrolled. The data analysis found significant differences between the self-reported and measured height [166 cm (147-191) vs. 164 cm (141-191) (p<0.0001)], weight [72.9 kg (38-149) vs. 73.1 kg (36-140) (p<0.0005)] and BMI [26.3 (16.2-46.4) vs. 27 (16-48.2) (p<0.0001)]. Of these patients, 119 (32%) reported an accurate height, 137 (37%) an accurate weight, and 54 (15%) an accurate BMI. None of the patients had two accurate measurements. The maximum underestimation was 18 kg for weight, 9 cm for height, and 6.15 kg/m
CONCLUSIONS
Although patients underestimated their weight and overestimated their height in our study, these had no impact on the perioperative AP regimens. However, this misreporting failed to detect potential contraindications to surgery.
LEVEL OF EVIDENCE
IV; retrospective study with prospective data collection and no control group.

Identifiants

pubmed: 37100170
pii: S1877-0568(23)00110-X
doi: 10.1016/j.otsr.2023.103627
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

103627

Informations de copyright

Copyright © 2023 Elsevier Masson SAS. All rights reserved.

Auteurs

Michael Butnaru (M)

Hôpital Diaconesses Croix Saint-Simon, 125, rue d'Avron, 75020 Paris, France. Electronic address: michaelbutnaru@gmail.com.

Matthieu Lalevée (M)

Service de chirurgie orthopédique et traumatologique, centre hospitalier universitaire de Rouen, 76000 Rouen, France.

Pierre-Alban Bouché (PA)

Hôpital Lariboisière, 2, rue Ambroise-Paré, 75010 Paris, France.

Thomas Aubert (T)

Hôpital Diaconesses Croix Saint-Simon, 125, rue d'Avron, 75020 Paris, France.

Antoine Mouton (A)

Hôpital Diaconesses Croix Saint-Simon, 125, rue d'Avron, 75020 Paris, France.

Blandine Marion (B)

Hôpital Diaconesses Croix Saint-Simon, 125, rue d'Avron, 75020 Paris, France.

Simon Marmor (S)

Hôpital Diaconesses Croix Saint-Simon, 125, rue d'Avron, 75020 Paris, France.

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