Early Intervention in Septic Arthritis of the Hand, Optimizing Patient Outcomes in Hand Infections—A Five-Year Retrospective Study
Abstract
1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Total (n = 74) | Outcome—Favorable (n = 49) | Outcome—Severe (n = 25) | |
---|---|---|---|
Sex, n (%) | |||
Males, n (%) | 47 (63.5%) | 29 (59.2%) | 18 (72%) |
Females, n (%) | 27 (36.5%) | 20 (40.8%) | 7 (28%) |
Anatomical site, n (%) | |||
Wrist, n (%) | 2 (2.7%) | 1 (2%) | 1 (4%) |
Thumb, n (%) | 16 (21.6%) | 9 (18.4%) | 7 (28%) |
Second finger, n (%) | 21 (28.4%) | 15 (30.6%) | 6 (24%) |
Third finger, n (%) | 20 (27%) | 12 (24.5%) | 8 (32%) |
Fourth finger, n (%) | 7 (9.5%) | 5 (10.2%) | 2 (8%) |
Fifth finger, n (%) | 8 (10.8%) | 7 (14.3%) | 1 (4%) |
Affected joint, n (%) | |||
RCJ, n (%) | 2 (2.7%) | 1 (2%) | 1 (4%) |
MPJ, n (%) | 30 (40.5%) | 26 (53%) | 4 (16%) |
PIPJ, n (%) | 24 (32.4%) | 17 (34.8%) | 7 (28%) |
DIPJ, n (%) | 9 (12.2%) | 2 (4.1%) | 7 (28%) |
Thumb IPJ, n (%) | 9 (12.2%) | 3 (6.1%) | 6 (24%) |
Etiology, n (%) | Total (n = 74) | Outcome—Favorable (n = 49) | Outcome—Severe (n = 25) |
---|---|---|---|
Bites, n (%) | 33 (44.6%) | 24 (49%) | 9 (36%) |
Bite (Dog), n (%) | 12 (16.2%) | 7 (14.3%) | 5 (20%) |
Bite (Cat), n (%) | 10 (13.5%) | 8 (16.3%) | 2 (8%) |
Bite (Human), n (%) | 10 (13.5%) | 9 (18.4%) | 1 (4%) |
Bite (Pig), n (%) | 1 (1.4%) | 0 | 1 (4%) |
Cuts, n (%) | 13 (17.6%) | 10 (20.4%) | 3 (12%) |
Cut (Electric handheld), n (%) | 4 (5.4%) | 2 (4.1%) | 2 (8%) |
Cut (Unknown), n (%) | 4 (5.4%) | 3 (6.1%) | 1 (4%) |
Cut (Knife), n (%) | 2 (2.7%) | 2 (4.1%) | 0 |
Cut (Glass), n (%) | 2 (2.7%) | 2 (4.1%) | 0 |
Cut (Axe), n (%) | 1 (1.4%) | 1 (2%) | 0 |
Stings, n (%) | 11 (14.9%) | 9 (18.4%) | 2 (8%) |
Unknown, n (%) | 5 (6.75%) | 3 (6.1%) | 2 (4.1%) |
Foreign body retention, n (%) | 3 (4.1%) | 3 (6.1%) | 0 |
Felons, n (%) | 3 (4.1%) | 0 | 3 (12%) |
Crush injury, n (%) | 2 (2.7%) | 0 | 2 (8%) |
Fall injury, n (%) | 2 (2.7%) | 0 | 2 (8%) |
Self-injection, n (%) | 1 (1.4%) | 0 | 1 (4%) |
Open joint dislocation, n (%) | 1 (1.4%) | 0 | 1 (4%) |
Total (n = 74) | Outcome–Favorable (n = 49) | Outcome—Severe (n = 25) | |
---|---|---|---|
Patients with comorbidities, n (%) | |||
Comorbidities absent, n (%) | 43 (58.1%) | 35 (71.4%) | 8 (32%) |
Single comorbidity, n (%) | 18 (24.3%) | 5 (10.2%) | 13 (52%) |
Multiple comorbidities, n (%) | 13 (17.6%) | 9 (18.4%) | 4 (16%) |
List of comorbidities, n (%) | |||
Arterial hypertension, n (%) | 17 (23%) | 8 (16.3%) | 9 (36%) |
Diabetes mellitus, n (%) | 11 (14.8%) | 3 (6.1%) | 8 (32%) |
Viral hepatitis, n (%) | 4 (5.4%) | 3 (6.1%) | 1 (4%) |
Alcohol abuse disorder, n (%) | 3 (4%) | 1 (2%) | 2 (8%) |
CKD, n (%) | 3 (4%) | 0 | 3 (12%) |
Autoimmune disease, n (%) | 3 (4%) | 0 | 3 (12%) |
Neoplasm, n (%) | 2 (2.7%) | 1 (2%) | 1 (4%) |
Heart disease, n (%) | 2 (2.7%) | 2 (4%) | 0 |
HIV, n (%) | 2 (2.7%) | 1 (2%) | 1 (4%) |
Total (n = 74) | Outcome—Favorable (n = 49) | Outcome—Severe (n = 25) | |
---|---|---|---|
Isolated pathogens, n (%) | Total (n = 59) | Susceptible to antibiotics (n = 49) | Multi drug resistant (n = 10) |
Staphylococcus aureus, n (%) | 15 (25.4%) | 12 (24.5%) | 3 (15.8%) |
| 4 (6.8%) | 2 (4.1%) | 2 (10.5%) |
| 11 (18.6%) | 10 (20.4%) | 1 (5.3%) |
Enterococcus spp., n (%) | 9 (15.3%) | 9 (18.4%) | 0 |
Coagulase negative staphylococcus, n (%) | 6 (10.2%) | 4 (8.2%) | 2 (10.5%) |
Escherichia coli, n (%) | 5 (8.5%) | 4 (8.2%) | 1 (5.3%) |
Proteus spp., n (%) | 4 (6.8%) | 3 (6.1%) | 1 (5.3%) |
Klebsiella pneumoniae, n (%) | 3 (5.1%) | 2 (4.1%) | 1 (5.3%) |
Streptococcus beta hemolytic, A group, n (%) | 2 (3.4%) | 1 (2.0%) | 1 (5.3%) |
Streptococcus beta hemolytic, F group, n (%) | 2 (3.4%) | 2 (4.1%) | 0 |
Streptococcus viridans, n (%) | 2 (3.4%) | 2 (4.1%) | 0 |
Streptococcus group D, n (%) | 2 (3.4%) | 2 (4.1%) | 0 |
Moraxella spp., n (%) | 1 (1.7%) | 1 (2.0%) | 0 |
Acinetobacter Iwoffi, n (%) | 1 (1.7%) | 1 (2.0%) | 0 |
Acinetobacter baumannii, n (%) | 1 (1.7%) | 1 (2.0%) | 0 |
Citrobacter spp., n (%) | 1 (1.7%) | 0 | 1 (5.3%) |
Providencia spp., n (%) | 1 (1.7%) | 1 (2.0%) | 0 |
Streptococcus beta hemolytic, C group, n (%) | 1 (1.7%) | 1 (2.0%) | 0 |
Streptococcus beta hemolytic, D group, n (%) | 1 (1.7%) | 1 (2.0%) | 0 |
Pasteurella canis, n (%) | 1 (1.7%) | 1 (2.0%) | 0 |
Streptococcus, group B, n (%) | 1 (1.7%) | 1 (2.0%) | 0 |
Total (n = 74) | Outcome—Favorable (n = 49) | Outcome—Severe (n = 25) | ||
---|---|---|---|---|
Age, n (%) | ||||
Age ≤ 64, n (%) | 56 (75.7%) | 40 (81.6%) | 16 (64%) | |
Age > 64, n (%) | 18 (24.3%) | 9 (18.4%) | 9 (36%) | p-value = 0.094498 (p-value > 0.05) |
Comorbidities, n (%) | ||||
Comorbidities absent, n (%) | 43 (58.1%) | 35 (71.4%) | 8 (32%) | |
Comorbidities present, n (%) | 31 (41.9%) | 14 (28.6%) | 17 (68%) | p-value = 0.001148 (p-value < 0.05) |
<Presentation date, n (%) | ||||
Early presentation (≤7 days), n (%) | 43 (58.1%) | 36 (73.5%) | 7 (28%) | |
Late presentation (>7 days), n (%) | 31 (41.9%) | 13 (26.5%) | 18 (72%) | p-value = 0.00046 (p-value < 0.05) |
Bacterial growth, n (%) | ||||
No bacterial growth, n (%) | 25 (33.8%) | 17 (34.7%) | 8 (32%) | |
Positive bacterial growth, n (%) | 49 (66.2%) | 32 (65.3%) | 17 (68%) | p-value = 1.0 (p-value > 0.05) |
Polymicrobial infected joints, n (%) | Total (n = 49) | Outcome—Favorable (n = 32) | Outcome—Unfavourable (n = 17) | |
Single bacteria isolated, n (%) | 36 (73.5%) | 26 (81.3%) | 10 (58.8%) | |
Multiple bacteria isolated, n (%) | 13 (36.5%) | 6 (18.7%) | 7 (41.2%) | p-value = 0.090546 (p-value > 0.05) |
Drug resistant bacteria, n (%) | Total (n = 49) | Outcome—Favourable (n = 32) | Outcome—Unfavourable (n = 17) | |
Non-MDR bacteria, n (%) | 39 (79.6%) | 27 (84.4%) | 12 (70.6%) | |
At least one MDR bacteria, n (%) | 10 (20.4%) | 5 (15.6%) | 5 (29.4%) | p-value of 0.254371 (p-value > 0.05) |
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Hodea, F.-V.; Grosu-Bularda, A.; Teodoreanu, R.N.; Cretu, A.; Ratoiu, V.-A.; Lascar, I.; Hariga, C.-S. Early Intervention in Septic Arthritis of the Hand, Optimizing Patient Outcomes in Hand Infections—A Five-Year Retrospective Study. Medicina 2024, 60, 895. https://doi.org/10.3390/medicina60060895
Hodea F-V, Grosu-Bularda A, Teodoreanu RN, Cretu A, Ratoiu V-A, Lascar I, Hariga C-S. Early Intervention in Septic Arthritis of the Hand, Optimizing Patient Outcomes in Hand Infections—A Five-Year Retrospective Study. Medicina. 2024; 60(6):895. https://doi.org/10.3390/medicina60060895
Chicago/Turabian StyleHodea, Florin-Vlad, Andreea Grosu-Bularda, Razvan Nicolae Teodoreanu, Andrei Cretu, Vladut-Alin Ratoiu, Ioan Lascar, and Cristian-Sorin Hariga. 2024. "Early Intervention in Septic Arthritis of the Hand, Optimizing Patient Outcomes in Hand Infections—A Five-Year Retrospective Study" Medicina 60, no. 6: 895. https://doi.org/10.3390/medicina60060895
APA StyleHodea, F.-V., Grosu-Bularda, A., Teodoreanu, R. N., Cretu, A., Ratoiu, V.-A., Lascar, I., & Hariga, C.-S. (2024). Early Intervention in Septic Arthritis of the Hand, Optimizing Patient Outcomes in Hand Infections—A Five-Year Retrospective Study. Medicina, 60(6), 895. https://doi.org/10.3390/medicina60060895