title: Deep wound infection after proximal femoral fracture: consequences and costs.
abstract: The purpose of this study was to assess the impact of deep wound infection after surgery for proximal femoral fracture (PFF) on the patient in terms of mortality and social consequences, and on the National Health Service in terms of financial burden. Sixty-one cases of PFF over a six-year period were complicated with deep surgical wound infection. These cases were compared with a matched control group of 122 patients without infection. Infected cases had greatly increased hospital stay (P<0.001), were 4.5 times less likely to survive to discharge (P=0.002), and if they survived, were three times less likely to return to their original residence (P=0.05). The total cost of treatment per infected case was 24,410 pound sterling compared with 7210 pound sterling for controls (P<0.001). Meticillin-resistant Staphylococcus aureus (MRSA) infection increased admission length and cost compared with non-MRSA infection (P=0.02). Deep wound infection after PFF is a devastating and costly complication for both the patient and the healthcare services. The cost consequences should be considered when allocating resources to trauma services to ensure adequate provision to minimize infection risks and to accommodate treatment costs in this vulnerable group.
authors.affiliation: Oxford Trauma Unit, The John Radcliffe Hospital, and Nuffield Department of Orthopaedic Surgery, University of Oxford, Oxford, UK. tcbpollard@hotmail.com
authors.forename: T C B
authors.initials: TC
authors.lastname: Pollard
authors.forename: J E
authors.initials: JE
authors.lastname: Newman
authors.forename: N J
authors.initials: NJ
authors.lastname: Barlow
authors.forename: J D
authors.initials: JD
authors.lastname: Price
authors.forename: K M
authors.initials: KM
authors.lastname: Willett
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D017281:Cost of Illness; D003428:Cross Infection / Q000191:economics* / Q000382:microbiology / Q000401:mortality*; D005260:Female; D005592:Fracture Fixation / Q000009:adverse effects*; D006620:Hip Fractures / Q000150:complications* / Q000601:surgery; D017721:Hospital Costs; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D016555:Matched-Pair Analysis; D012086:Reoperation; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000191:economics* / Q000382:microbiology / Q000401:mortality* / Q000628:therapy; D006113:United Kingdom / Q000453:epidemiology