Risk Factors for Surgical Site Infections After Orthopaedic Surgery in the Ambulatory Surgical Center Setting
Robert H Brophy1, Anchal Bansal, Brandon L Rogalski
1From the Department of Orthopaedic Surgery, Washington University, St. Louis, MO (Dr. Brophy, Bansal, Rogalski, Rizzo, Weiner, and Dr. Goldfarb), and the Department of Anesthesia, Washington University, Barnes-Jewish West County Hospital, Creve Coeur, MO (Dr. Wolff).
Introduction:
This study was designed to determine the incidence of surgical site infections (SSIs) after orthopaedic surgery in an ambulatory surgery center (ASC) and to identify patient and surgical risk factors associated with SSI.
Methods:
Patients who underwent orthopaedic surgery at an ASC over a 6.5-year period were reviewed for evidence of SSI. Data on patient and surgical factors were collected, and stepwise multivariate logistic regression determined the risk factors for SSI.
Results:
The incidence of SSIs was 0.32%. Five independent factors were associated with SSI: anatomic area (odds ratio [OR] = 18.60, 11.24, 6.75, and 4.01 for the hip, foot/ankle, knee/leg, and hand/elbow versus shoulder, respectively), anesthesia type (OR = 4.49 combined general and regional anesthesia versus general anesthesia), age ≥70 (OR = 2.85), diabetes mellitus (OR = 2.27), and tourniquet time (OR = 1.01 per minute tourniquet time).
Discussion:
The risk of infection after orthopaedic surgery in ASCs is low, but patient and surgical factors are independently associated with SSIs.
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