title: Risk factors of surgical site infections in hip hemiarthroplasty: a single-institution experience over nine years.
abstract: BACKGROUND
  This study aims to describe the factors associated with surgical site infection (SSI) in elderly patients who underwent hip hemiarthroplasty following a hip fracture, in a single institution over a nine-year period.
  
  
  METHODS
  All patients who underwent hip hemiarthroplasty between 1 January 2004 and 31 December 2012 in our hospital were included in the present study. The detection of SSI was carried out by a trained, independent infection control nurse using the United States Centers for Disease Control and Prevention criteria. Demographic and clinical data were collected retrospectively. Demographics and clinical factors were analysed for potential associations with SSI.
  
  
  RESULTS
  Among the 1,320 patients who met the study inclusion criteria, a total 57 SSIs were documented, giving an infection rate of 4.3%. Patients who waited for more than one week for surgery had a statistically significantly higher risk of SSI (odds ratio 3.030, 95% confidence interval 1.075-8.545, p = 0.036). The presence of SSI was also significantly associated with increased length of hospital stay (p < 0.001). The two main microorganisms detected were methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa, which accounted for 50.9% and 26.3% of the SSIs, respectively.
  
  
  CONCLUSIONS
  We concluded that the number of days from admission to surgery is a main risk factor for the development of SSI. Steps should, therefore, be taken to prevent unnecessary delay of surgery in elderly patients requiring hip hemiarthroplasty.
authors: Department of Orthopaedic Surgery, Changi General Hospital, 2 Simei Street 3, Singapore 529889.
authors: Adrian Cheng Kiang
authors: AC
authors: Lau
authors: Ghim Hoe
authors: GH
authors: Neo
authors: Haw Chou
authors: HC
authors: Lee
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D062785:Hemiarthroplasty / Q000009:adverse effects*; D006621:Hip Joint / Q000601:surgery*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology*
references: Am J Infect Control. 1991 Feb;19(1):19-35
references: 1850582
references: Infect Control Hosp Epidemiol. 1992 Oct;13(10):606-8
references: 1334988
references: J Bone Joint Surg Am. 1995 Oct;77(10):1551-6
references: 7593064
references: J Bone Joint Surg Am. 2005 Mar;87(3):483-9
references: 15741611
references: J Bone Joint Surg Br. 2005 Jun;87(6):844-50
references: 15911671
references: J Bone Joint Surg Am. 2006 Aug;88(8):1705-12
references: 16882891
references: Public Health Rep. 2007 Mar-Apr;122(2):160-6
references: 17357358
references: Can J Anaesth. 2008 Mar;55(3):146-54
references: 18310624
references: BMJ. 2010;340:c1199
references: 20234041
references: Clin Orthop Relat Res. 2013 Oct;471(10):3112-9
references: 23519927
references: Infect Control Hosp Epidemiol. 2002 Apr;23(4):183-9
references: 12002232
references: Clin Infect Dis. 2003 Dec 1;37(11):1453-60
references: 14614667