Pre-operative urinary tract infection: is it a risk factor for early surgical site infection with hip fracture surgery? A retrospective analysis.
OBJECTIVE
The aims of the current study were to determine whether pre-operative urinary tract infections in patients presenting acutely with neck of femur fractures resulted in a delay to surgery and whether such patients were at increased risk of developing post-operative surgical site infections.


METHODS
A retrospective review of all patients presenting with a neck of femur fracture, at a single centre over a one-year period. The hospital hip fracture database was used as the main source of data.


METHODS
UK University Teaching Hospital.


METHODS
All patients (n= 460) presenting across a single year study period with a confirmed hip fracture.


METHODS
The presence of pre-operative urinary tract infection, the timing of surgical intervention, the occurrence of post-operative surgical site infection and the pathogens identified.


RESULTS
A total of 367 patients were operated upon within 24 hours of admission. Urinary infections were the least common cause of delay. A total of 99 patients (21.5%) had pre-operative urinary tract infection. Post-operatively, a total of 57 (12.4%) patients developed a surgical site infection. Among the latter, 31 (54.4%) did not have a pre-operative urinary infection, 23 (40.4%) patients had a pre-operative urinary tract infection, 2 had chronic leg ulcers and one patient had a pre-operative chest infection. Statistically, there was a strong relationship between pre-operative urinary tract infection and the development of post-operative surgical site infection (p-value: 0.0005).


CONCLUSIONS
The results of our study indicate that pre-operative urinary tract infection has a high prevalence amongst those presenting with neck of femur fractures, and this is a risk factor for the later development of post-operative surgical site infection.
Department of Trauma and Orthopaedics, Health Education England North West, Manchester M1 3BN, UK.
Rafik Rd
RR
Yassa
Department of Trauma and Orthopaedics, Northwest Deanery, Manchester M1 3BN, UK.
Mahdi Y
MY
Khalfaoui
Department of Trauma and Orthopaedics, Morriston Hospital, Swansea SA6 6NL, UK.
Karunakar
K
Veravalli
Department of Trauma and Orthopaedics, Morriston Hospital, Swansea SA6 6NL, UK.
D Alun
DA
Evans
Hip; delay; infection; urinary