title: Hand infection patients presenting to an orthopaedic unit: An audit of incidence and demographics at a rural hospital.
abstract: OBJECTIVE
  Hand infections are a common presentation to health services in the Northern Territory; however, little is known about these patients. This study aims to identify incidence, treatment and co-morbidities of hand infection patients and to pinpoint factors associated with poor outcome.
  
  
  METHODS
  A retrospective study of all patients presenting to Alice Springs Hospital with a hand infection during 2012.
  
  
  METHODS
  Orthopaedic Unit at Alice Springs Hospital.
  
  
  METHODS
  All patients admitted with a hand infection were included.
  
  
  METHODS
  Admission duration, duration waited before first presentation, re-admission rate, duration of re-admission and rate of methicillin-resistant Staphylococcus aureus.
  
  
  RESULTS
  One hundred fourteen cases of hand infections were admitted to Alice Springs Hospital during 2012, of which 87 (76%) were in Indigenous patients. Indigenous patients (P = 0.001) and older patients (P = 0.038) had significantly longer admissions. Indigenous patients were 9.52 times (P = 0.038) more likely to be re-admitted than non-Indigenous patients. The rate of methicillin-resistant Staphylococcus aureus was 24.6%, and this was associated with smoking (P = 0.049) and substance abuse (P = 0.036). Formal follow-up was not related to indirect measures of hand infection severity, such as admission duration or re-admissions.
  
  
  CONCLUSIONS
  Hand infections are a common presentation to Alice Springs Hospital. Indigenous people are admitted 2.38 times longer after adjusting for age and alcohol abuse. They have a more than ninefold chance of being re-admitted to hospital than non-Indigenous people following a hand infection.
authors.affiliation: Orthopaedics, Flinders Medical Centre, Alice Springs, Northern Territory, Australia.
authors.forename: Arthur
authors.initials: A
authors.lastname: Turow
authors.affiliation: Orthopaedics, Alice Springs Hospital, Alice Springs, Northern Territory, Australia.
authors.forename: Bandulasena
authors.initials: B
authors.lastname: Palapitige
authors.affiliation: Epidemiology and Biostatistics, Flinders University, Adelaide, South Australia.
authors.forename: Susan W
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Orthopaedics, Flinders Medical Centre, Alice Springs, Northern Territory, Australia.
authors.forename: Ruurd L
authors.initials: RL
authors.lastname: Jaarsma
authors.affiliation: Orthopaedics, Flinders Medical Centre, Alice Springs, Northern Territory, Australia.
authors.forename: Donald
authors.initials: D
authors.lastname: Bramwell
authors.affiliation: Orthopaedics, Flinders Medical Centre, Alice Springs, Northern Territory, Australia.
authors.forename: Jeganath
authors.initials: J
authors.lastname: Krishnan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006225:Hand / Q000382:microbiology*; D006780:Hospitals, Rural; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008485:Medical Audit; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D008875:Middle Aged; D009985:Orthopedics; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000453:epidemiology*; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013289:Streptococcaceae / Q000302:isolation & purification; D055815:Young Adult
keywords: MRSA; aboriginal health; hand infection; orthopaedics; trauma