Length of preoperative hospital stay: a risk factor for reducing surgical infection in femoral fracture cases

Abstract

ObjectiveTo analyze infections of the surgical site among patients undergoing clean-wound surgery for correction of femoral fractures.MethodsThis was a historical cohort study developed in a large-sized hospital in Belo Horizonte. Data covering the period from July 2007 to July 2009 were gathered from the records in electronic medical files, relating to the characteristics of the patients, surgical procedures and surgical infections. The risk factors for infection were identified by means of statistical tests on bilateral hypotheses, taking the significance level to be 5%. Continuous variables were evaluated using Student's t test. Categorical variables were evaluated using the chi-square test, or Fisher's exact test, when necessary. For each factor under analysis, a point estimate and the 95% confidence interval for the relative risk were obtained. In the final stage of the study, multivariate logistic regression analysis was performed.Results432 patients who underwent clean-wound surgery for correcting femoral fractures were included in this study. The rate of incidence of surgical site infections was 4.9% and the risk factors identified were the presence of stroke (odds ratio, OR = 5.0) and length of preoperative hospital stay greater than four days (OR = 3.3).ConclusionTo prevent surgical site infections in operations for treating femoral fractures, measures involving assessment of patients’ clinical conditions by a multiprofessional team, reduction of the length of preoperative hospital stay and prevention of complications resulting from infections will be necessary.

Risk factors for postoperative infection after gastrointestinal surgery among adult patients with inflammatory bowel disease: Findings from a large observational US cohort study

“…In our study, we also found a preoperative hospital stay for at least 4 days to be an independent predictor for POI. A presurgical hospital stay of more than 4 days has been reported to be associated with higher risk of POI in inpatients recovering from trauma (OR 1.58, 95% CI 1.1–2.35) as well as in orthopedic patients (OR 3.3, 95% CI 2.5–4.0) . While appropriate to minimize surgical delay in hospitalized IBD patients, this may not be clinically feasible.…”

“…A presurgical hospital stay of more than 4 days has been reported to be associated with higher risk of POI in inpatients recovering from trauma (OR 1.58, 95% CI 1.1-2.35) 25 as well as in orthopedic patients (OR 3.3, 95% CI 2.5-4.0). 26,27 While appropriate to minimize surgical delay in hospitalized IBD patients, this may not be clinically feasible. Although other risk factors including history of POI, history of COPD, and RBC transfusion within 6 months are not modifiable, surgeons may consider patients with these risk factors at a higher risk of POI.…”

Examination of Risk Factors for the Development of Surgical Site Infections

“…In the study conducted by Pereira and associates, it was established that the patients who had pre-operatively stayed in hospital longer than 4 days acquired SSIs three times more frequently (OR=3.3) ( 17 ).…”

Detection of Surgical Site Infection Utilizing Automated Feature Generation in Clinical Notes

“…Postsurgical complications (PSCs) are defined as a deviation from the normal postsurgical course and can be divided into minor and major complications or graded by severity and treatment requirements [2]. A large number of risk factors are related to PSCs including type and extent of the surgical procedure, perioperative bleeding, anesthetic method, patient's age, condition and nutritional state [3][4][5][6][7][8][9]. By recent statistics, there are nearly 234 million major surgical procedures are conducted all around the world each year comprises the rates of major PSCs ranging from 3% to 16% [10].…”