Risk factors of surgical site infections in hip hemiarthroplasty: a single-institution experience over nine years

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.

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.

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.

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.