Incidence and risk of surgical site infection after adult femoral neck fractures treated by surgery

Ji, Chenni; Zhu, Yanbin; Liu, Song; Li, Jia; Zhang, Fei; Chen, Wei; Zhang, Yingze

doi:10.1097/md.0000000000014882

Cited by 23 publications

(26 citation statements)

References 50 publications

(47 reference statements)

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“…Femoral neck fractures usually occur following falls, which are very common in the geriatric population, accounting for 48.22% of hip fractures and 3.13% of all fractures in adults. 1 With ageing populations, an increase in the number of femoral neck fractures is inevitable; age-associated low bone mineral density, malnutrition and accompanying vitamin depletion, as well as the presence of other pre-existing risk factors, makes the geriatric population especially susceptible to fracture. There are a number of treatment options for fractures of the femoral neck, including hemiarthroplasty (HA), arthroplasty (THA), internal fixation and non-operative treatment.…”

Section: Introductionmentioning

confidence: 99%

<p>Preoperative Serum Albumin Level As A Predictor Of Postoperative Pneumonia After Femoral Neck Fracture Surgery In A Geriatric Population</p>

Wang¹,

Li²,

Ji³

et al. 2019

CIA

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Purpose: Femoral neck fracture usually occurs in the geriatric population. Postoperative pneumonia (POP) is known to be devastated, and it is the most frequent complication among patients receiving surgical treatment for femoral neck fractures. However, whether patients who have hypoalbuminaemia are susceptible to the development of POP is a serious concern, although it has not been investigated. We attempted to investigate the association between newly developed POP and hypoalbuminaemia and to identify whether hypoalbuminaemia is an independent risk factor for POP after femoral neck fracture in geriatric population. Patients and methods: We retrospectively reviewed the records from the first 30 days after surgery of patients who were ≥65 years of age and who had a femoral neck fracture treated with surgery between January 2018 and December 2018 at the Honghui Hospital, Xi'an Jiaotong University. Patients were divided into two groups based on whether they did or did not experience POP, and their clinical characteristics were compared. Binomial logistic regression was used to identify potential risk factors of POP by analysing demographic factors, preoperative comorbidities, laboratory results, and surgical factors. Results: A total of 720 patients were included in the analysis, and 54 patients experienced POP. The incidence of POP after surgical treatment for a femoral neck fracture in this geriatric population was 7.5%. In addition, patients with POP had significantly longer hospital stays than patients without POP. The binary logistic regression analysis revealed that preoperative hypoalbuminaemia [odds ratio =5.187, 95% confidence interval (CI): 2.561-10.506, P<0.0001], COPD (OR =3.819, 95% CI: 1.247-11.701, P=0.019), prior stroke (OR =3.107, 95% CI: 1.470-6.568, P=0.003) and the time from injury to surgery (OR =1.076, 95% CI: 1.034-1.119, P<0.0001) were predominant and independent risk factors associated with POP after femoral neck fracture in this geriatric population. Conclusion: The current study revealed that among a geriatric population admitted for femoral neck fracture surgery, preoperative hypoalbuminaemia was a predictor of POP, followed by COPD, prior stroke and the time from injury to surgery. Thus, patients who undergo femoral neck fracture surgery and have preoperative hypoalbuminaemia should receive additional monitoring and perioperative care.

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Section: Introductionmentioning

confidence: 99%

<p>Preoperative Serum Albumin Level As A Predictor Of Postoperative Pneumonia After Femoral Neck Fracture Surgery In A Geriatric Population</p>

Wang¹,

Li²,

Ji³

et al. 2019

CIA

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“…[38] Chenni Ji et al performed a retrospective study of 692 patients with femoral neck fractures and also found that low HGB level is risk factor of SSIs. [30] These results indicate the importance of low hemoglobin levels in the development of SSIs. In high-risk patients with multiple risk factors, preoperative mandatory optimization should be considered.…”

Section: Risk Factorsmentioning

confidence: 84%

“…We identify femoral fractures and tibia and bula fractures as independent risk factors for surgical site infection of limb fractures, consistent with the infection rates we have observed in the previous literature. [29,30,37] The location of femoral fracture is deep, and the trauma caused to the body during the reduction of fracture is large, which may be the reason for the higher risk of infection after femoral fracture surgery. Besides, relatively longer bed time is usually required after femoral fracture surgey, which also increase the risk of SSI.…”

Section: Risk Factorsmentioning

confidence: 99%

Microbiology Characteristics and Risk Factors of Surgical Site Infection in Limb Fractures: a Single-center Retrospective Study

Luo

Chen

Zhang

et al. 2021

Preprint

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Background: Limb fractures were becoming more common, and internal fixation increased the risk of surgical site infection. The purpose of this study was to identified risk factors for surgical site infection and the factors that affected the microbiological characteristics.Material and methods: Data from patients with limb fractures who received internal fixation between January 2010 and January 2020 were included. Univariate and multivariate logistic analyses were performed to determine independent risk factors.Results: A total of 4479 patients were identified and 187 (4.18%) patients developed surgical site infections (SSI). Staphylococcus aureus (25.1%) was the most common bacteria, followed by Coagulase negative Staphylococcus (18.8%) and Acinetobacter baumannii (12.0%). Multiple regression analysis revealed that low total protein (OR, 4.066; 95% CI, 1.217-13.583) and high white blood cell count (OR, 3.133; 95% CI, 1.291-7.605) were risk factors for gram-negative bacteria infection. Five risk factors were identified to be independently associated with the development of SSIs, including current smoking (OR, 2.923; 95% CI, 1.294-6.599), high-energy injury (OR, 2.816; 95% CI, 1.368-5.799), femoral fracture, tibia and fibula fracture, vascular injury at the fracture site (OR, 10.284; 95% CI, 2.506-42.199), skin contusin at the fracture site (OR, 3.348; 95% CI, 1.304-8.574), hypohemoglobin (OR, 2.991; 95% CI, 1.422-6.292).Conclusion: Preoperative preventative measures should be taken in patients at high risk to reduce the incidence of SSIs.

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“…Among the risk factors associated with SSI occurrence, the most prevalent are those related to inadequate wound healing (smoking (12), old age (13), obesity, malnutrition ( 14 surgeries, operative time and type of anesthesia have also been described (17).…”

Section: Discussionmentioning

confidence: 99%

Surgical site infection in adults undergoing major non-cardiac surgery and its association with anemia, severe bleeding and intraoperative transfusion: A preliminary report from a prospective registry

Ariza¹,

Castaño²,

Bolaños-Aldana³

et al. 2020

Colomb. j. anesthesiol.

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Introduction Surgical site infection (SSI) is among the most common healthcare-related infections. Given their greater morbidity and surgical complexity, patients undergoing major surgery are exposed to a high risk of SSI. Objective To determine the incidence of SSI in adult patients undergoing major elective non-cardiac surgery, and to identify risk factors associated with its occurrence within the first 30 days after surgery. Methods An analytical study was designed on the basis of a prospective institutional registry. Clinical and laboratory variables associated with perioperative management were recorded. An active search was conducted in order to find SSI episodes, renal failure and multiple organ dysfunction during the first 30 days after surgery. Adjusted logistic regression was done to identify potential associations between risk factors and the development of SSI. Results Overall, 1501 patients were included. The incidence of SSI during the first 30 days after surgery was 6.72% (95% CI 5.57-8.11). ASA III, abdominal surgery and longer procedures were more frequent in the SSI group. Association with the occurrence of SSI was documented for preoperative hemoglobin levels (adjusted OR 0.79 [95% CI 0.72-0.88], p = 0.04), intraoperative transfusion (adjusted OR 2,47 [95% CI 1.16-5.27], p = 0.02) and major blood loss (adjusted OR 3.80 [95% CI 1.63-8.88], p = 0.04). Conclusion Preoperative hemoglobin level, intraoperative transfusion and major bleeding are independent risk factors associated with the occurrence of SSI in adult patients undergoing major elective non-cardiac surgery.

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Incidence and risk of surgical site infection after adult femoral neck fractures treated by surgery

Cited by 23 publications

References 50 publications

<p>Preoperative Serum Albumin Level As A Predictor Of Postoperative Pneumonia After Femoral Neck Fracture Surgery In A Geriatric Population</p>

<p>Preoperative Serum Albumin Level As A Predictor Of Postoperative Pneumonia After Femoral Neck Fracture Surgery In A Geriatric Population</p>

Microbiology Characteristics and Risk Factors of Surgical Site Infection in Limb Fractures: a Single-center Retrospective Study

Surgical site infection in adults undergoing major non-cardiac surgery and its association with anemia, severe bleeding and intraoperative transfusion: A preliminary report from a prospective registry

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