{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T00:13:37Z","timestamp":1794010417995,"version":"4.8.0"},"reference-count":63,"publisher":"Deutscher Arzte-Verlag GmbH","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"DOI":"10.3238\/arztebl.m2023.0233","type":"journal-article","created":{"date-parts":[[2023,12,22]],"date-time":"2023-12-22T07:13:45Z","timestamp":1703229225000},"source":"Crossref","is-referenced-by-count":36,"title":["Fracture-related infection\u2014epidemiology, etiology, diagnosis, prevention, and treatment"],"prefix":"10.3238","author":[{"given":"Markus","family":"Rupp","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nike","family":"Walter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"B\u00e4rtl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Heyd","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Hitzenbichler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volker","family":"Alt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"11437","published-online":{"date-parts":[[2024,1,12]]},"reference":[{"key":"10.3238\/arztebl.m2023.0233_ref1","doi-asserted-by":"crossref","unstructured":"Walter N, Rupp M, Lang S, Alt V: The epidemiology of fracture-related infections in Germany. Sci Rep 2021; 11: 10443.","DOI":"10.1038\/s41598-021-90008-w"},{"key":"10.3238\/arztebl.m2023.0233_ref2","unstructured":"Rupp M, Walter N, Pfeifer C, et al.: The incidence of fractures among the adult population of Germany—an analysis from 2009 through 2019. Dtsch Arztebl Int 2021; 118: 665–9."},{"key":"10.3238\/arztebl.m2023.0233_ref3","doi-asserted-by":"crossref","unstructured":"Metsemakers WJ, Morgenstern M, McNally MA, et al.: Fracture-related infection: a consensus on definition from an international expert group. Injury 2018; 49: 505–10.","DOI":"10.1016\/j.injury.2017.08.040"},{"key":"10.3238\/arztebl.m2023.0233_ref4","doi-asserted-by":"crossref","unstructured":"Ktistakis I, Giannoudi M, Giannoudis PV: Infection rates after open tibial fractures: are they decreasing? Injury 2014; 45: 1025–7.","DOI":"10.1016\/j.injury.2014.03.022"},{"key":"10.3238\/arztebl.m2023.0233_ref5","doi-asserted-by":"crossref","unstructured":"Trampuz A, Zimmerli W: Diagnosis and treatment of infections associated with fracture-fixation devices. Injury 2006; 37 (Suppl 2): 59–66.","DOI":"10.1016\/j.injury.2006.04.010"},{"key":"10.3238\/arztebl.m2023.0233_ref6","doi-asserted-by":"crossref","unstructured":"Rupp M, Baertl S, Walter N, Hitzenbichler F, Ehrenschwender M, Alt V: Is there a difference in microbiological epidemiology and effective empiric antimicrobial therapy comparing fracture-related infection and periprosthetic joint infection? A retrospective comparative study. Antibiotics (Basel) 2021; 10: 921.","DOI":"10.3390\/antibiotics10080921"},{"key":"10.3238\/arztebl.m2023.0233_ref7","doi-asserted-by":"crossref","unstructured":"Depypere M, Sliepen J, Onsea J, et al.: The microbiological etiology of fracture-related infection. Front Cell Infect Microbiol 2022; 12: 934485.","DOI":"10.3389\/fcimb.2022.934485"},{"key":"10.3238\/arztebl.m2023.0233_ref8","doi-asserted-by":"crossref","unstructured":"Corrigan RA, Sliepen J, Dudareva M, et al.: Causative pathogens do not differ between early, delayed or late fracture-related infections. Antibiotics (Basel) 2022; 11: 943.","DOI":"10.3390\/antibiotics11070943"},{"key":"10.3238\/arztebl.m2023.0233_ref9","doi-asserted-by":"crossref","unstructured":"Baertl S, Walter N, Engelstaedter U, et al.: What is the most effective empirical antibiotic treatment for early, delayed, and late fracture-related infections? Antibiotics (Basel) 2022; 11: 287.","DOI":"10.3390\/antibiotics11030287"},{"key":"10.3238\/arztebl.m2023.0233_ref10","doi-asserted-by":"crossref","unstructured":"Berr\u00edos-Torres SI, Umscheid CA, Bratzler DW, et al.: Centers for disease control and prevention guideline for the prevention of surgical site infection, 2017. JAMA Surg 2017; 152: 784–91.","DOI":"10.1001\/jamasurg.2017.0904"},{"key":"10.3238\/arztebl.m2023.0233_ref11","unstructured":"Global guidelines for the prevention of surgical site infection. Geneva, Switzerland: World Health Organization 2018."},{"key":"10.3238\/arztebl.m2023.0233_ref12","doi-asserted-by":"crossref","unstructured":"Broach RB, Paulson EC, Scott C, Mahmoud NN: Randomized controlled trial of two alcohol-based preparations for surgical site antisepsis in colorectal surgery. Ann Surg 2017; 266: 946–51.","DOI":"10.1097\/SLA.0000000000002189"},{"key":"10.3238\/arztebl.m2023.0233_ref13","doi-asserted-by":"crossref","unstructured":"Depypere M, Morgenstern M, Kuehl R, et al.: Pathogenesis and management of fracture-related infection. Clin Microbiol Infect 2020; 26: 572–8.","DOI":"10.1016\/j.cmi.2019.08.006"},{"key":"10.3238\/arztebl.m2023.0233_ref14","doi-asserted-by":"crossref","unstructured":"Kortram K, Bezstarosti H, Metsemakers WJ, Raschke MJ, van Lieshout EMM, Verhofstad MHJ: Risk factors for infectious complications after open fractures; a systematic review and meta-analysis. Int Orthop 2017; 41: 1965–82.","DOI":"10.1007\/s00264-017-3556-5"},{"key":"10.3238\/arztebl.m2023.0233_ref15","doi-asserted-by":"crossref","unstructured":"Metsemakers WJ, Onsea J, Neutjens E, et al.: Prevention of fracture-related infection: a multidisciplinary care package. Int Orthop 2017; 41: 2457–69.","DOI":"10.1007\/s00264-017-3607-y"},{"key":"10.3238\/arztebl.m2023.0233_ref16","doi-asserted-by":"crossref","unstructured":"Kasatpibal N, Whitney JD, Dellinger EP, Nair BG, Pike KC: Failure to redose antibiotic prophylaxis in long surgery increases risk of surgical site infection. Surg Infect (Larchmt) 2017; 18: 474–84.","DOI":"10.1089\/sur.2016.164"},{"key":"10.3238\/arztebl.m2023.0233_ref17","doi-asserted-by":"crossref","unstructured":"Hoff WS, Bonadies JA, Cachecho R, Dorlac WC: East Practice Management Guidelines Work Group: update to practice management guidelines for prophylactic antibiotic use in open fractures. J Trauma 2011; 70: 751–4.","DOI":"10.1097\/TA.0b013e31820930e5"},{"key":"10.3238\/arztebl.m2023.0233_ref18","doi-asserted-by":"crossref","unstructured":"Messner J, Papakostidis C, Giannoudis PV, Kanakaris NK: Duration of administration of antibiotic agents for open fractures: meta-analysis of the existing evidence. Surg Infect (Larchmt) 2017; 18: 854–67.","DOI":"10.1089\/sur.2017.108"},{"key":"10.3238\/arztebl.m2023.0233_ref19","doi-asserted-by":"crossref","unstructured":"Morgenstern M, Vallejo A, McNally MA, et al.: The effect of local antibiotic prophylaxis when treating open limb fractures: a systematic review and meta-analysis. Bone Joint Res 2018; 7: 447–56.","DOI":"10.1302\/2046-3758.77.BJR-2018-0043.R1"},{"key":"10.3238\/arztebl.m2023.0233_ref20","doi-asserted-by":"crossref","unstructured":"Haykal S, Roy M, Patel A: Meta-analysis of timing for microsurgical free-flap reconstruction for lower limb injury: evaluation of the godina principles. J Reconstr Microsurg 2018; 34: 277–92.","DOI":"10.1055\/s-0037-1621724"},{"key":"10.3238\/arztebl.m2023.0233_ref21","doi-asserted-by":"crossref","unstructured":"Bhandari M, Jeray KJ, Petrisor BA, et al.: A trial of wound irrigation in the initial management of open fracture wounds. N Engl J Med 2015; 373: 2629–41.","DOI":"10.1056\/NEJMoa1508502"},{"key":"10.3238\/arztebl.m2023.0233_ref22","doi-asserted-by":"crossref","unstructured":"Rupp M, Popp D, Alt V: Prevention of infection in open fractures: where are the pendulums now? Injury 2020; 51 (Suppl 2): S57–S63.","DOI":"10.1016\/j.injury.2019.10.074"},{"key":"10.3238\/arztebl.m2023.0233_ref23","doi-asserted-by":"crossref","unstructured":"Alt V: Antimicrobial coated implants in trauma and orthopaedics—a clinical review and risk-benefit analysis. Injury 2017; 48: 599–607.","DOI":"10.1016\/j.injury.2016.12.011"},{"key":"10.3238\/arztebl.m2023.0233_ref24","doi-asserted-by":"crossref","unstructured":"Toon CD, Lusuku C, Ramamoorthy R, Davidson BR, Gurusamy KS: Early versus delayed dressing removal after primary closure of clean and clean-contaminated surgical wounds. Cochrane Database Syst Rev 2015; 2015: CD010259.","DOI":"10.1002\/14651858.CD010259.pub3"},{"key":"10.3238\/arztebl.m2023.0233_ref25","doi-asserted-by":"crossref","unstructured":"Rupp M, Walter N, Popp D, et al.: Multidisciplinary treatment of fracture-related infection has a positive impact on clinical outcome—a retrospective case control study at a tertiary referral center. Antibiotics (Basel) 2023; 12: 230.","DOI":"10.3390\/antibiotics12020230"},{"key":"10.3238\/arztebl.m2023.0233_ref26","doi-asserted-by":"crossref","unstructured":"Morgenstern M, Kuehl R, Zalavras CG, et al.: The influence of duration of infection on outcome of debridement and implant retention in fracture-related infection. Bone Joint J 2021; 103: 213–21.","DOI":"10.1302\/0301-620X.103B2.BJJ-2020-1010.R1"},{"key":"10.3238\/arztebl.m2023.0233_ref27","doi-asserted-by":"crossref","unstructured":"Mifsud M, Ferguson JY, Stubbs DA, Ramsden AJ, McNally MA: Simultaneous debridement, Ilizarov reconstruction and free muscle flaps in the management of complex tibial infection. J Bone Jt Infect 2020; 6: 63–72.","DOI":"10.5194\/jbji-6-63-2020"},{"key":"10.3238\/arztebl.m2023.0233_ref28","doi-asserted-by":"crossref","unstructured":"McNally MA, Ferguson JY, Scarborough M, Ramsden A, Stubbs DA, Atkins BL: Mid- to long-term results of single-stage surgery for patients with chronic osteomyelitis using a bioabsorbable gentamicin-loaded ceramic carrier. Bone Joint J 2022; 104: 1095–100.","DOI":"10.1302\/0301-620X.104B9.BJJ-2022-0396.R1"},{"key":"10.3238\/arztebl.m2023.0233_ref29","doi-asserted-by":"crossref","unstructured":"Sliepen J, Corrigan RA, Dudareva M, et al.: Does the use of local antibiotics affect clinical outcome of patients with fracture-related infection? Antibiotics (Basel) 2022; 11: 1330.","DOI":"10.3390\/antibiotics11101330"},{"key":"10.3238\/arztebl.m2023.0233_ref30","doi-asserted-by":"crossref","unstructured":"McNally M, Corrigan R, Sliepen J, et al.: What factors affect outcome in the treatment of fracture-related infection? Antibiotics (Basel) 2022; 11: 946.","DOI":"10.3390\/antibiotics11070946"},{"key":"10.3238\/arztebl.m2023.0233_ref31","doi-asserted-by":"crossref","unstructured":"Sweere V, Sliepen J, Haidari S, et al.: Use of negative pressure wound therapy in patients with fracture-related infection more than doubles the risk of recurrence. Injury 2022; 53: 3938–44.","DOI":"10.1016\/j.injury.2022.10.014"},{"key":"10.3238\/arztebl.m2023.0233_ref32","doi-asserted-by":"crossref","unstructured":"Haidari S, IJpma FFA, Metsemakers WJ, et al.: The role of negative-pressure wound therapy in patients with fracture-related infection: a systematic review and critical appraisal. Biomed Res Int 2021; 2021: 7742227.","DOI":"10.1155\/2021\/7742227"},{"key":"10.3238\/arztebl.m2023.0233_ref33","doi-asserted-by":"crossref","unstructured":"Bezstarosti H, van Lieshout EMM, Voskamp LW, et al.: Insights into treatment and outcome of fracture-related infection: a systematic literature review. Arch Orthop Trauma Surg 2019; 139: 61–72.","DOI":"10.1007\/s00402-018-3048-0"},{"key":"10.3238\/arztebl.m2023.0233_ref34","doi-asserted-by":"crossref","unstructured":"Wright JG, Swiontkowski MF, Heckman JD: Introducing levels of evidence to the journal. J Bone Joint Surg Am 2003; 85: 1–3.","DOI":"10.2106\/00004623-200301000-00001"},{"key":"10.3238\/arztebl.m2023.0233_ref35","doi-asserted-by":"crossref","unstructured":"Patterson JT, Becerra JA, Brown M, Roohani I, Zalavras C, Carey JN: Antibiotic bead pouch versus negative pressure wound therapy at initial management of AO\/OTA 42 type IIIB open tibia fracture may reduce fracture related infection: a retrospective analysis of 113 patients. Injury 2023; 54: 744–50.","DOI":"10.1016\/j.injury.2022.12.018"},{"key":"10.3238\/arztebl.m2023.0233_ref36","doi-asserted-by":"crossref","unstructured":"Buijs MAS, van den Kieboom J, Sliepen J, et al.: Outcome and risk factors for recurrence of early onset fracture-related infections treated with debridement, antibiotics and implant retention: results of a large retrospective multicentre cohort study. Injury 2022; 53: 3930–7.","DOI":"10.1016\/j.injury.2022.10.017"},{"key":"10.3238\/arztebl.m2023.0233_ref37","doi-asserted-by":"crossref","unstructured":"Rupp M, Kern S, Weber T, et al.: Polymicrobial infections and microbial patterns in infected nonunions—a descriptive analysis of 42 cases. BMC Infect Dis 2020; 20: 667.","DOI":"10.1186\/s12879-020-05386-9"},{"key":"10.3238\/arztebl.m2023.0233_ref38","doi-asserted-by":"crossref","unstructured":"Kadhim M, Holmes L, Gesheff MG, Conway JD: Treatment options for nonunion with segmental bone defects: systematic review and quantitative evidence synthesis. J Orthop Trauma 2017; 31: 111–9.","DOI":"10.1097\/BOT.0000000000000700"},{"key":"10.3238\/arztebl.m2023.0233_ref39","doi-asserted-by":"crossref","unstructured":"Depypere M, Kuehl R, Metsemakers WJ, et al.: Recommendations for systemic antimicrobial therapy in fracture-related infection: a consensus from an international expert group. J Orthop Trauma 2020; 34: 30–41.","DOI":"10.1097\/BOT.0000000000001626"},{"key":"10.3238\/arztebl.m2023.0233_ref40","doi-asserted-by":"crossref","unstructured":"Court-Brown CM, McQueen MM: Global forum: fractures in the elderly. J Bone Joint Surg Am 2016; 98: e36.","DOI":"10.2106\/JBJS.15.00793"},{"key":"10.3238\/arztebl.m2023.0233_ref41","doi-asserted-by":"crossref","unstructured":"Fonkoue L, Tissingh EK, Muluem OK, et al.: Predictive factors for fracture-related infection in open tibial fractures in a sub-saharan african setting. Injury 2023: 54: 110816.","DOI":"10.1016\/j.injury.2023.05.047"},{"key":"10.3238\/arztebl.m2023.0233_ref42","doi-asserted-by":"crossref","unstructured":"Arciola CR, Campoccia D, Montanaro L: Implant infections: adhesion, biofilm formation and immune evasion. Nat Rev Microbiol 2018; 16: 397–409.","DOI":"10.1038\/s41579-018-0019-y"},{"key":"10.3238\/arztebl.m2023.0233_ref43","doi-asserted-by":"crossref","unstructured":"Kuehl R, Tschudin-Sutter S, Morgenstern M, et al.: Time-dependent differences in management and microbiology of orthopaedic internal fixation-associated infections: an observational prospective study with 229 patients. Clin Microbiol Infect 2019; 25: 76–81.","DOI":"10.1016\/j.cmi.2018.03.040"},{"key":"10.3238\/arztebl.m2023.0233_ref44","doi-asserted-by":"crossref","unstructured":"Wang B, Xiao X, Zhang J, Han W, Hersi SA, Tang X: Epidemiology and microbiology of fracture-related infection: a multicenter study in Northeast China. J Orthop Surg Res 2021; 16: 490.","DOI":"10.1186\/s13018-021-02629-6"},{"key":"10.3238\/arztebl.m2023.0233_ref45","doi-asserted-by":"crossref","unstructured":"Momaya AM, Hlavacek J, Etier B, et al.: Risk factors for infection after operative fixation of tibial plateau fractures. Injury 2016; 47: 1501–5.","DOI":"10.1016\/j.injury.2016.04.011"},{"key":"10.3238\/arztebl.m2023.0233_ref46","doi-asserted-by":"crossref","unstructured":"Arens S, Hansis M, Schlege U, et al.: Infection after open reduction and internal fixation with dynamic compression plates—Clinical and experimental data. Injury 1996; 27 (Suppl 3): 27–33.","DOI":"10.1016\/0020-1383(96)89029-2"},{"key":"10.3238\/arztebl.m2023.0233_ref47","doi-asserted-by":"crossref","unstructured":"Renz N, Cabric S, Janz V, Trampuz A: Sonikation in der Diagnostik periprothetischer Infektionen Stellenwert und praktische Umsetzung. Orthopade 2015; 44: 942–5.","DOI":"10.1007\/s00132-015-3192-y"},{"key":"10.3238\/arztebl.m2023.0233_ref48","doi-asserted-by":"crossref","unstructured":"Lack WD, Karunakar MA, Angerame MR, et al.: Type III open tibia fractures: immediate antibiotic prophylaxis minimizes infection. J Orthop Trauma 2015; 29: 1–6.","DOI":"10.1097\/BOT.0000000000000262"},{"key":"10.3238\/arztebl.m2023.0233_ref49","doi-asserted-by":"crossref","unstructured":"Lucke M, Schmidmaier G, Sadoni S, et al.: Gentamicin coating of metallic implants reduces implant-related osteomyelitis in rats. Bone 2003; 32: 521–31.","DOI":"10.1016\/S8756-3282(03)00050-4"},{"key":"10.3238\/arztebl.m2023.0233_ref50","doi-asserted-by":"crossref","unstructured":"Fabritius M, Al-Munajjed AA, Freytag C, et al.: Antimicrobial silver multilayer coating for prevention of bacterial colonization of orthopedic implants. Materials (Basel) 2020; 13: 1415.","DOI":"10.3390\/ma13061415"},{"key":"10.3238\/arztebl.m2023.0233_ref51","doi-asserted-by":"crossref","unstructured":"Fuchs T, Stange R, Schmidmaier G, Raschke MJ: The use of gentamicin-coated nails in the tibia: preliminary results of a prospective study. Arch Orthop Trauma Surg 2011; 131: 1419–25.","DOI":"10.1007\/s00402-011-1321-6"},{"key":"10.3238\/arztebl.m2023.0233_ref52","doi-asserted-by":"crossref","unstructured":"Schmidmaier G, Kerstan M, Schwabe P, S\u00fcdkamp N, Raschke M: Clinical experiences in the use of a gentamicin-coated titanium nail in tibia fractures. Injury 2017; 48: 2235–41.","DOI":"10.1016\/j.injury.2017.07.008"},{"key":"10.3238\/arztebl.m2023.0233_ref53","doi-asserted-by":"crossref","unstructured":"Metsemakers WJ, Reul M, Nijs S: The use of gentamicin-coated nails in complex open tibia fracture and revision cases: a retrospective analysis of a single centre case series and review of the literature. Injury 2015; 46: 2433–7.","DOI":"10.1016\/j.injury.2015.09.028"},{"key":"10.3238\/arztebl.m2023.0233_ref54","doi-asserted-by":"crossref","unstructured":"Metsemakers WJ, Morgenstern M, Senneville E, et al.: General treatment principles for fracture-related infection: recommendations from an international expert group. Arch Orthop Trauma Surg 2020; 140: 1013–27.","DOI":"10.1007\/s00402-019-03287-4"},{"key":"10.3238\/arztebl.m2023.0233_ref55","doi-asserted-by":"crossref","unstructured":"Rupp M, B\u00e4rtl S, Lang S, et al.: Frakturassoziierte Infektionen nach Marknagelosteosynthese: Diagnostik und Therapie. Unfallchirurg 2022; 12550–58.","DOI":"10.1007\/s00113-021-01117-0"},{"key":"10.3238\/arztebl.m2023.0233_ref56","doi-asserted-by":"crossref","unstructured":"Foster AL, Moriarty TF, Zalavras C, et al.: The influence of biomechanical stability on bone healing and fracture-related infection: the legacy of Stephan Perren. Injury 2021; 52: 43–52.","DOI":"10.1016\/j.injury.2020.06.044"},{"key":"10.3238\/arztebl.m2023.0233_ref57","doi-asserted-by":"crossref","unstructured":"Hoit G, Bonyun M, Nauth A: Hardware considerations in infection and nonunion management: when and how to revise the fixation. OTA Int 2020; 3: e055.","DOI":"10.1097\/OI9.0000000000000055"},{"key":"10.3238\/arztebl.m2023.0233_ref58","doi-asserted-by":"crossref","unstructured":"Rupp M, Kern S, Walter N, et al.: Surgical treatment outcome after serial debridement of infected nonunion—a retrospective cohort study. Eur J Orthop Surg Traumatol 2022; 32: 183–9.","DOI":"10.1007\/s00590-021-02930-4"},{"key":"10.3238\/arztebl.m2023.0233_ref59","doi-asserted-by":"crossref","unstructured":"Rupp M, Walter N, Szymski D, Taeger C, Langer MF, Alt V: The antibiotic bead pouch—a useful technique for temporary soft tissue coverage, infection prevention and therapy in trauma surgery. J Bone Joint Infect 2023; 8: 165–73.","DOI":"10.5194\/jbji-8-165-2023"},{"key":"10.3238\/arztebl.m2023.0233_ref60","doi-asserted-by":"crossref","unstructured":"Masquelet A, Kanakaris NK, Obert L, Stafford P, Giannoudis PV: Bone repair using the masquelet technique. J Bone Joint Surg Am 2019; 101: 1024–36.","DOI":"10.2106\/JBJS.18.00842"},{"key":"10.3238\/arztebl.m2023.0233_ref61","doi-asserted-by":"crossref","unstructured":"Hei\u00df C, Rupp M, Knapp G: Knochenersatz und Knochenaufbau. Z Orthop Unfall 2019; 157: 715–28.","DOI":"10.1055\/a-0756-2768"},{"key":"10.3238\/arztebl.m2023.0233_ref62","doi-asserted-by":"crossref","unstructured":"Kadhim M, Holmes L, Gesheff MG, Conway JD: Treatment options for nonunion with segmental bone defects: systematic review and quantitative evidence synthesis. J Orthop Trauma 2017; 31: 111–9.","DOI":"10.1097\/BOT.0000000000000700"},{"key":"10.3238\/arztebl.m2023.0233_ref63","doi-asserted-by":"crossref","unstructured":"Okazaki F, Tsuji Y, Seto Y, Ogami C, Yamamoto Y, To H: Effects of a rifampicin pre-treatment on linezolid pharmacokinetics. PLoS One 2019; 14: e0214037.","DOI":"10.1371\/journal.pone.0214037"}],"container-title":["Deutsches \u00c4rzteblatt international"],"original-title":[],"link":[{"URL":"https:\/\/www.aerzteblatt.de\/10.3238\/arztebl.m2023.0233","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,22]],"date-time":"2023-12-22T07:14:34Z","timestamp":1703229274000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.aerzteblatt.de\/10.3238\/arztebl.m2023.0233"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,12]]},"references-count":63,"URL":"https:\/\/doi.org\/10.3238\/arztebl.m2023.0233","relation":{},"ISSN":["1866-0452"],"issn-type":[{"value":"1866-0452","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,12]]}}}