Early infection after hip fracture surgery: risk factors, costs and outcome.
Prospective data on hip fracture from 3686 patients at a United Kingdom teaching hospital were analysed to investigate the risk factors, financial costs and outcomes associated with deep or superficial wound infections after hip fracture surgery. In 1.2% (41) of patients a deep wound infection developed, and 1.1% (39) had a superficial wound infection. A total of 57 of 80 infections (71.3%) were due to Staphylococcus aureus and 39 (48.8%) were due to MRSA. No statistically significant pre-operative risk factors were detected. Length of stay, cost of treatment and pre-discharge mortality all significantly increased with deep wound infection. The one-year mortality was 30%, and this increased to 50% in those who developed an infection (p < 0.001). A deep infection resulted in doubled operative costs, tripled investigation costs and quadrupled ward costs. MRSA infection increased costs, length of stay, and pre-discharge mortality compared with non-MRSA infection.
Department of Orthopaedics and Trauma, University Hospital, Nottingham, Nottingham NG7 2UH, UK.
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Edwards
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Counsell
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Boulton
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Moran
D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation / Q000379:methods; D004739:England; D004812:Epidemiologic Methods; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D016106:Methicillin Resistance; D011184:Postoperative Period; D011379:Prognosis; D013203:Staphylococcal Infections / Q000191:economics / Q000209:etiology; D013211:Staphylococcus aureus / Q000187:drug effects; D013530:Surgical Wound Infection / Q000191:economics / Q000209:etiology*