Early infection after hip fracture surgery: risk factors, costs and outcome

J Bone Joint Surg Br. 2008 Jun;90(6):770-7. doi: 10.1302/0301-620X.90B6.20194.

Abstract

Prospective data on hip fracture from 3686 patients at a United Kingdom teaching hospital were analysed to investigate the risk factors, financial costs and outcomes associated with deep or superficial wound infections after hip fracture surgery. In 1.2% (41) of patients a deep wound infection developed, and 1.1% (39) had a superficial wound infection. A total of 57 of 80 infections (71.3%) were due to Staphylococcus aureus and 39 (48.8%) were due to MRSA. No statistically significant pre-operative risk factors were detected. Length of stay, cost of treatment and pre-discharge mortality all significantly increased with deep wound infection. The one-year mortality was 30%, and this increased to 50% in those who developed an infection (p < 0.001). A deep infection resulted in doubled operative costs, tripled investigation costs and quadrupled ward costs. MRSA infection increased costs, length of stay, and pre-discharge mortality compared with non-MRSA infection.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip / instrumentation
  • Arthroplasty, Replacement, Hip / methods
  • England
  • Epidemiologic Methods
  • Female
  • Fracture Fixation, Internal / instrumentation
  • Fracture Fixation, Internal / methods
  • Health Care Costs / statistics & numerical data*
  • Hip Fractures / surgery*
  • Humans
  • Length of Stay
  • Male
  • Methicillin Resistance
  • Postoperative Period
  • Prognosis
  • Staphylococcal Infections / economics
  • Staphylococcal Infections / etiology
  • Staphylococcus aureus / drug effects
  • Surgical Wound Infection / economics
  • Surgical Wound Infection / etiology*