Surgical site infection following traumatic orthopaedic surgeries in geriatric patients: Incidence and prognostic risk factors

Abstract

Geriatric population is increasing rapidly worldwide, and fragility fracture and complication following orthopaedic surgery in elderly people have now become major challenges for surgeons. Further studies are required to identify potentially modifiable factors associated with surgical site infection (SSI) in geriatric patients. This retrospective, multicenter study was conducted at four level I hospitals in China. During the 31-month study period, a total of 2341 patients (65 years or older) underwent orthopaedic surgery and complete data were recorded from September 2015 to April 2018. Demographics information, medications and additional comorbidities, surgery-related variables, and laboratory indexes were extracted and analysed. Receiver-operating characteristic analysis was performed to detect the optimum threshold of continuous variables. Independent risk factors of SSI were identified by univariate and multivariate analyses. Finally, 63 patients suffered from wound infection within the follow-up period, indicating a 2.7% incidence rate of SSI. Statistical results showed that open injury (odds ratio [OR], 9.5; 95% confidence interval [CI], 5.4-16.7), American Society of Anesthesiologists classified III-IV score (OR, 2.2; 95% CI, 1.3-3.8), surgical duration of >132 minutes (OR, 2.9; 95% CI, 1.1-5.0), serum albumin (ALB) of <36.4 mg/L (OR, 2.0; 95% CI, 1.6-3.4), and blood glucose (GLU) of >118 mg/dL (OR, 3.1; 95% CI, 1.1-5.3) were independent risk factors of postoperative SSI. With the application of sensitive and modifiable variables such as surgical duration and the levels of ALB and GLU, more geriatric patients with sub-high risk of postoperative SSI could be identified.

Incidence and risk factors of surgical site infection after intertrochanteric fracture surgery: A prospective cohort study

“…5 Surgical site infection (SSI) is a challenging postoperative complication for the patient and hospital, the rate of which following hip fractures is between 2.7% and 14.9%. [6][7][8] It not only leads to more hospital stay, poor functional outcomes, and greater costs but also results in a substantially increased mortality risk. 9,10 A variety of risk factors of SSI were documented, including age, comorbidities, obesity, the experience of the surgeon, haematoma, surgical duration, increased duration of anaesthesia, body mass index (BMI), current smoking, preoperative hospital stay, serum albumin, warfarin treatment, and so forth.…”

“…In previous studies, postoperative complications have been attributed to be one of the leading causes of death in hip fractures patients 5 . Surgical site infection (SSI) is a challenging postoperative complication for the patient and hospital, the rate of which following hip fractures is between 2.7% and 14.9% 6‐8 . It not only leads to more hospital stay, poor functional outcomes, and greater costs but also results in a substantially increased mortality risk 9,10 …”

Predictive factors of surgical site infection after hysterectomy for endometrial carcinoma: a retrospective analysis

“…Endometrial carcinoma is one of the common malignant tumors in gynecology, the catabolism of albumin increases accordingly, the amount of albumin required for repairing surgical site increases [ 37 ]. Lower albumin level indicates the lack of albumin, which is harmful to the recovery of surgical site [ 38 , 39 ]. The intimate detection of serum albumin level is necessary for the postoperative patients.…”

Análise das infecções de sítio cirúrgico em pacientes ortopédicos de um hospital do Paraná

“…Em relação ao caráter da cirurgia, ela pode ser eletiva, com agendamento prévio e com preparação do paciente e da ISC apenas na população idosa (65 anos ou mais), 84,1% dos idosos, tiveram a infecção relacionada a cirurgias de caráter emergencial. Isso pode ser explicado, pelo fato de que, estudos mostraram uma maior prevalência de ISC em cirurgias de pacientes geriátricos (Le et al, 2020).…”