title: Should hip fractures be operated upon only by specialist hip unit surgeons in order to lower rates of surgical site infection?
abstract: OBJECTIVE
  The purpose of this study was to compare outcomes of hip fractures treated by orthopaedic surgeons, performed by specialist vs. non-specialist surgeons. The rate of surgical site infection (SSI) obtained is taken as the main variable.
  
  
  METHODS
  This was a prospective controlled cohort study of 814 patients presenting with hip fractures, operated on by a group of orthopaedic surgeons within the same hospital department. Patients were classified according to whether the surgeons belonged to a specialist hip unit (group A = 212 cases) or not (group B = 602 cases).
  
  
  RESULTS
  Multivariate logistic regression showed that there was no relation between gender, SSI, Charlson's index, preoperative period, surgical technique or study groups (A or B). Only age was a determinant factor (rank-sum test p = 0.03; OR 95% CI = 1.07, p = 0.005).
  
  
  CONCLUSIONS
  Since there were no differences in the SSI outcome between surgeons working in a specialist hip unit and the general orthopaedic surgeons, delaying operative treatment for hip fractures to enable treatment in such a unit or creating a new unit of this type is not necessary. In this respect, the only significant variable is the patient's age.
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Hospital Costa del Sol, University of Malaga, Autovía A-7 Km.187, 29603, Marbella, Malaga, Spain, eguerado@hcs.es.
authors.forename: Enrique
authors.initials: E
authors.lastname: Guerado
authors.forename: Juan R
authors.initials: JR
authors.lastname: Cano
authors.forename: Encarnacion
authors.initials: E
authors.lastname: Cruz
authors.forename: María Luisa
authors.initials: ML
authors.lastname: Bertrand
authors.forename: Miguel
authors.initials: M
authors.lastname: Hirschfeld
authors.forename: Nicolas
authors.initials: N
authors.lastname: Benitez-Parejo
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000379:methods*; D011446:Prospective Studies; D013038:Specialization; D066231:Surgeons; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D016896:Treatment Outcome