title: Risk factors for postoperative infections in patients with hip fracture treated by means of Thompson arthroplasty.
abstract: Specific conditions associated with surgery may predispose elderly people to septic complications after hip fracture surgery. This study investigated the risk factors predisposing infection in aged patients with subcapital hip fracture. We performed a prospective study of 290 patients with displaced subcapital hip fracture, operated by means of Thompson hip hemi-arthroplasty (83.5% fractures in women). The mean age was 85.42+/-6.06 years (ranging from 69 to 104). Follow-up was realized until death or at least for 2 years. The chi(2) test, analysis of variance, Kruskal-Wallis test, correlation analysis and the Spearman test were applied. Odds ratios (OR) were calculated. During the hospital stay, there were diagnosed 94 urinary tract infections, 25 pneumonias, 50 superficial wound infections, 11 deep wound infections. Transfusions were made in 120 patients (in average: 2.54+/-1.45 units of red cell concentrate/transfused patient). Transfusion appeared to be correlated with superficial wound infection (OR=1.96), urinary infection (OR=1.76) and pneumonia (OR=2.85). Higher number of days waiting for surgery were related significantly with pneumonia (9.8+/-7.44 days vs. 6.39+/-3.75), or urinary tract infection (7.76+/-4.39 days vs. 6.17+/-4.14). We concluded that the transfusion and longer waiting time for surgery have been associated with the septic complications in elderly patients treated surgically for hip fracture.
authors.affiliation: Traumatology and Orthopedic Surgery, Area III, Surgery Department, Faculty of Medicine, University of Zaragoza, c/Domingo Miral s/n, Zaragoza 50.009, Spain. fegarcia@comz.org
authors.forename: F
authors.initials: F
authors.lastname: García-Alvarez
authors.forename: R
authors.initials: R
authors.lastname: Al-Ghanem
authors.forename: I
authors.initials: I
authors.lastname: García-Alvarez
authors.forename: A
authors.initials: A
authors.lastname: López-Baisson
authors.forename: M
authors.initials: M
authors.lastname: Bernal
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods; D001803:Blood Transfusion / Q000379:methods; D016009:Chi-Square Distribution; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects / Q000379:methods; D015577:Geriatric Assessment; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D011014:Pneumonia / Q000175:diagnosis / Q000453:epidemiology; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology; D011336:Probability; D011859:Radiography; D018570:Risk Assessment; D012720:Severity of Illness Index; D013030:Spain; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000453:epidemiology*; D015996:Survival Rate; D065227:Transfusion Reaction; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000453:epidemiology*