You probably realise this, but if he's close to the border between two "continuous" classes, and the two classes have very different risks of X, it probably doesn't mean that his risk is one or the other depending on what class he's put in. More likely, his personal risk is in between those numbers, and to know more, you'd need more data about how the risk numbers were derived.
E.g., if the 5% risk for that class were based on 10,000 people all with injuries very similar to his but maybe not quite as bad, while the 40% class were based on 100 people 80 of whom had injuries far worse than his, then you'd probably be justified in thinking his personal risk were much closer to 5% than 40%. But of course, you'd only get that kind of information impressionistically and informally, since if the numbers were really well known, they'd probably revise the classification to take account of that knowledge.
Yeah, I know. There are a ton of other factors, too - degree of contamination, time to surgery, etc. But since knowing his actual risk has zero practical value (nothing would change based on it), I'm not unhappy just saying "15-20% is a reasonable estimate," rather than trying to get a more-accurate number. Particularly since it doesn't matter whether he has a 1% risk or a 99% risk, but whether he actually gets an infection.
Plus I'm not sure there are good numbers available. The 15-20% comment was in a study looking at 13 years of cases, and they only had a sample size of 43 or so.
Yes, risk is a slippery thing. I well remember, when I pressed the ICU consultant for numbers about the prognosis of people in ICU, him saying "it's not one-third of J who will be coming out of here". Glad your dad seems to be doing so well.
As an update to this, I just came across a medical text (http://www.amazon.com/gp/product/1416022201 - thank goodness for Google Books!) that said an open femur fracture is by definition Grade III (because of the amount of trauma it takes to cause an open femur fracture), but because there's so much soft tissue in your thigh, you almost never see a Grade III B femur fracture. So between that and the fact that there was absolutely no indication of infection when they took out the spacers and did the graft, and there's been absolutely no indication of infection since that surgery, I'd guess there's a negligible risk of a serious infection setting in at some point in the future.
Yes, and the fact that he's focused that stubbornness on being able to do stuff, rather than lying in bed waiting to die. A week ago, it took two PT people all their strength to drag him into his chair; today, he got himself in and out with just someone to move the chair into place and to get the slider sheet under his legs. (Plus a hospital bed with a trapeze hung from it, but hey, he's still got two broken legs and a broken pelvis.) Being able to move around with just someone with no skills and no particular strength is a huge benefit - Alex could have done it.
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E.g., if the 5% risk for that class were based on 10,000 people all with injuries very similar to his but maybe not quite as bad, while the 40% class were based on 100 people 80 of whom had injuries far worse than his, then you'd probably be justified in thinking his personal risk were much closer to 5% than 40%. But of course, you'd only get that kind of information impressionistically and informally, since if the numbers were really well known, they'd probably revise the classification to take account of that knowledge.
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Plus I'm not sure there are good numbers available. The 15-20% comment was in a study looking at 13 years of cases, and they only had a sample size of 43 or so.
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Go, your dad. Do you think his personal orneriness is actually helping him at this point?
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