Factors affecting the incidence of surgical site infection after geriatric hip fracture surgery: a retrospective multice
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(2019) 14:382
RESEARCH ARTICLE
Open Access
Factors affecting the incidence of surgical site infection after geriatric hip fracture surgery: a retrospective multicenter study Xiaopo Liu1*†, Zhijie Dong2†, Jun Li3†, Yunbo Feng1, Guolong Cao1, Xin Song4 and Jie Yang5
Abstract Background: Geriatric hip fracture is a common type of osteoporotic fracture with high mortality and disability; surgical site infection (SSI) can be a devastating complication of this injury. By far, only a few studies identified easily remediable factors to reduce infection rates following hip fracture and less researches have focused on geriatric patients. The objective of this study was to identify potentially modifiable factors associated with SSI following geriatric hip fracture surgery. Methods: This retrospective, multicenter study involves three level I hospitals. A total of 1240 patients (60 years or older) underwent hip surgery with complete data were recruited between January 2016 and June 2018. Demographics information, medications and additional comorbidities, operation-related variables, and laboratory indexes were extracted and analyzed. Receiver operating characteristic (ROC) analysis was performed to detect the optimum cut-off value for quantitative data. Univariate and multivariate logistic analysis model were performed respectively to identify the independent predictors. Results: Ninety-four (7.58%) patients developed SSI in this study, and 76 (6.13%) had superficial infection, while 18 (1.45%) were diagnosed with deep infection. Results of univariate and multivariate analysis showed age > 79 years (OR, 2.60; p < 0.001), BMI > 26.6 kg/m2 (OR, 2.97; p < 0.001), operating time > 107 min (OR, 2.18; p = 0.001), and ALB < 41.6 g/L (OR, 2.01; p = 0.005) were associated with an increased incidence of SSI; drainage use (OR, 0.57; p = 0.007) could reduce the incidence of wound infection for patients after geriatric hip fracture. Conclusion: Accurate modifiable variables, operating time > 107 min, serum albumin < 41.6 g/L, BMI > 26.6 kg/m2, and age > 79 years could be applied to distinguish geriatric patients with high-risk of postoperative surgical site infection. Keywords: Geriatric patients, Hip fracture, Risk factors, Serum albumin, SSI Hip fracture is a common type of osteoporotic fracture, with high mortality and disability. Previous study, in the UK, has reported that there are more than 86,000 hip fractures annually [1], and in the next 40 to 50 years, more than 7 million patients with hip fractures are anticipated worldwide each year [2], and more than 50% of all osteoporotic hip fractures will occur in Asia owing to the growing population size [3]. With the austere circumstance of aging population all over the word, * Correspondence: [email protected] † Xiaopo Liu, Zhijie Dong and Jun Li contributed equally to this work. 1 Third Department of Orthopaedics, Tangshan Gongren Hospital, Tangshan, Hebei 063000, People’s Republic of China Full list of author information is available at the end of the article
geriatric hip fractur
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