Modifiable Factors as Current Smoking, Hypoalbumin, and Elevated Fasting Blood Glucose Level Increased the SSI Risk Following Elderly Hip Fracture Surgery
Objective: Surgical site infection (SSI) following hip fractures represents an important complication. This study aimed to investigate the incidence rate after surgery of hip fractures in the elderly and to identify the associated risk factors. Patients: Patients’ demographic, injury, and surgery-re...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2020-09-01
|
| Series: | Journal of Investigative Surgery |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/08941939.2018.1556364 |
| _version_ | 1797684687287615488 |
|---|---|
| author | Tianxiao Ma Kaosheng Lu Lihua Song Dongyue Wang Shenghua Ning Ziqi Chen Zhanyong Wu |
| author_facet | Tianxiao Ma Kaosheng Lu Lihua Song Dongyue Wang Shenghua Ning Ziqi Chen Zhanyong Wu |
| author_sort | Tianxiao Ma |
| collection | DOAJ |
| description | Objective: Surgical site infection (SSI) following hip fractures represents an important complication. This study aimed to investigate the incidence rate after surgery of hip fractures in the elderly and to identify the associated risk factors. Patients: Patients’ demographic, injury, and surgery-related data and biochemical indexes were retrospectively reviewed and recorded during their hospitalization, between July 2015 and June 2017. After their discharge from hospital, patients were prospectively followed up at postoperative 1, 3, 6, and 12 months. SSIs were identified by review of patients’ medical records and post-discharge telephone follow-up. Univariate and multivariate analyses were performed to determine the independent risk factors associated with SSI. Results: A total of 611 patients undergoing surgery for hip fractures with complete data were included for analysis. During the postoperative one year, 27 SSIs (19 superficial and 8 deep SSIs) developed, indicating the cumulative incidence of 4.4% (95%CI, 2.8–6.0%). Of them, 21 (77.8%) SSIs were detected during patients’ hospitalization, and the 6 (22.2%) cases were confirmed via telephone during the post-discharge follow-up. After adjustment of multiple variables, BMI, current smoking, surgical duration, preoperative hospital stay, ASA class of III-IV, ALB <35g/L, and FBG > 110mg/dL were identified as independent risk factors for SSI. Conclusions: Three modifiable factors as smoking, preoperative ALB <35g/L, and FBG > 110mg/dL should be optimized preoperatively to reduce the SSIs. Other factors, although not modifiable, could be used for screening of at-risk patients, patient risk stratification, or for counseling of patients. |
| first_indexed | 2024-03-12T00:33:19Z |
| format | Article |
| id | doaj.art-a1b090e257074583ac1cc84960adfa3d |
| institution | Directory Open Access Journal |
| issn | 0894-1939 1521-0553 |
| language | English |
| last_indexed | 2024-03-12T00:33:19Z |
| publishDate | 2020-09-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Journal of Investigative Surgery |
| spelling | doaj.art-a1b090e257074583ac1cc84960adfa3d2023-09-15T10:07:29ZengTaylor & Francis GroupJournal of Investigative Surgery0894-19391521-05532020-09-0133875075810.1080/08941939.2018.15563641556364Modifiable Factors as Current Smoking, Hypoalbumin, and Elevated Fasting Blood Glucose Level Increased the SSI Risk Following Elderly Hip Fracture SurgeryTianxiao Ma0Kaosheng Lu1Lihua Song2Dongyue Wang3Shenghua Ning4Ziqi Chen5Zhanyong Wu6The General Hospital of Jizhong Energy Xingtai Mining GroupThe General Hospital of Jizhong Energy Xingtai Mining GroupThe General Hospital of Jizhong Energy Xingtai Mining GroupThe General Hospital of Jizhong Energy Xingtai Mining GroupThe General Hospital of Jizhong Energy Xingtai Mining GroupThe General Hospital of Jizhong Energy Xingtai Mining GroupThe General Hospital of Jizhong Energy Xingtai Mining GroupObjective: Surgical site infection (SSI) following hip fractures represents an important complication. This study aimed to investigate the incidence rate after surgery of hip fractures in the elderly and to identify the associated risk factors. Patients: Patients’ demographic, injury, and surgery-related data and biochemical indexes were retrospectively reviewed and recorded during their hospitalization, between July 2015 and June 2017. After their discharge from hospital, patients were prospectively followed up at postoperative 1, 3, 6, and 12 months. SSIs were identified by review of patients’ medical records and post-discharge telephone follow-up. Univariate and multivariate analyses were performed to determine the independent risk factors associated with SSI. Results: A total of 611 patients undergoing surgery for hip fractures with complete data were included for analysis. During the postoperative one year, 27 SSIs (19 superficial and 8 deep SSIs) developed, indicating the cumulative incidence of 4.4% (95%CI, 2.8–6.0%). Of them, 21 (77.8%) SSIs were detected during patients’ hospitalization, and the 6 (22.2%) cases were confirmed via telephone during the post-discharge follow-up. After adjustment of multiple variables, BMI, current smoking, surgical duration, preoperative hospital stay, ASA class of III-IV, ALB <35g/L, and FBG > 110mg/dL were identified as independent risk factors for SSI. Conclusions: Three modifiable factors as smoking, preoperative ALB <35g/L, and FBG > 110mg/dL should be optimized preoperatively to reduce the SSIs. Other factors, although not modifiable, could be used for screening of at-risk patients, patient risk stratification, or for counseling of patients.http://dx.doi.org/10.1080/08941939.2018.1556364ssielderly hip fractureincidencerisk factormodifiablemultivariate analysis |
| spellingShingle | Tianxiao Ma Kaosheng Lu Lihua Song Dongyue Wang Shenghua Ning Ziqi Chen Zhanyong Wu Modifiable Factors as Current Smoking, Hypoalbumin, and Elevated Fasting Blood Glucose Level Increased the SSI Risk Following Elderly Hip Fracture Surgery Journal of Investigative Surgery ssi elderly hip fracture incidence risk factor modifiable multivariate analysis |
| title | Modifiable Factors as Current Smoking, Hypoalbumin, and Elevated Fasting Blood Glucose Level Increased the SSI Risk Following Elderly Hip Fracture Surgery |
| title_full | Modifiable Factors as Current Smoking, Hypoalbumin, and Elevated Fasting Blood Glucose Level Increased the SSI Risk Following Elderly Hip Fracture Surgery |
| title_fullStr | Modifiable Factors as Current Smoking, Hypoalbumin, and Elevated Fasting Blood Glucose Level Increased the SSI Risk Following Elderly Hip Fracture Surgery |
| title_full_unstemmed | Modifiable Factors as Current Smoking, Hypoalbumin, and Elevated Fasting Blood Glucose Level Increased the SSI Risk Following Elderly Hip Fracture Surgery |
| title_short | Modifiable Factors as Current Smoking, Hypoalbumin, and Elevated Fasting Blood Glucose Level Increased the SSI Risk Following Elderly Hip Fracture Surgery |
| title_sort | modifiable factors as current smoking hypoalbumin and elevated fasting blood glucose level increased the ssi risk following elderly hip fracture surgery |
| topic | ssi elderly hip fracture incidence risk factor modifiable multivariate analysis |
| url | http://dx.doi.org/10.1080/08941939.2018.1556364 |
| work_keys_str_mv | AT tianxiaoma modifiablefactorsascurrentsmokinghypoalbuminandelevatedfastingbloodglucoselevelincreasedthessiriskfollowingelderlyhipfracturesurgery AT kaoshenglu modifiablefactorsascurrentsmokinghypoalbuminandelevatedfastingbloodglucoselevelincreasedthessiriskfollowingelderlyhipfracturesurgery AT lihuasong modifiablefactorsascurrentsmokinghypoalbuminandelevatedfastingbloodglucoselevelincreasedthessiriskfollowingelderlyhipfracturesurgery AT dongyuewang modifiablefactorsascurrentsmokinghypoalbuminandelevatedfastingbloodglucoselevelincreasedthessiriskfollowingelderlyhipfracturesurgery AT shenghuaning modifiablefactorsascurrentsmokinghypoalbuminandelevatedfastingbloodglucoselevelincreasedthessiriskfollowingelderlyhipfracturesurgery AT ziqichen modifiablefactorsascurrentsmokinghypoalbuminandelevatedfastingbloodglucoselevelincreasedthessiriskfollowingelderlyhipfracturesurgery AT zhanyongwu modifiablefactorsascurrentsmokinghypoalbuminandelevatedfastingbloodglucoselevelincreasedthessiriskfollowingelderlyhipfracturesurgery |