Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Sep 21:93:760-766.
doi: 10.2340/17453674.2022.4580.

Risk of reoperation due to surgical site infection in 74,771 hip fracture patients: a Danish nationwide cohort study

Nicolai K Kristensen  1 , Jeppe Lange  2 , Trine Frøslev  3 , Alma B Pedersen  4
Affiliations

Risk of reoperation due to surgical site infection in 74,771 hip fracture patients: a Danish nationwide cohort study

Nicolai K Kristensen et al. Acta Orthop. .

Erratum in

Abstract

Background and purpose: Surgical site infection (SSI) after hip fracture surgery is a feared condition. We examined the trend in incidence of reoperation due to SSI up to 1 year following hip fracture surgery from 2005 to 2016 and risk factors of SSI by age, sex, comorbidity, type of fracture, and surgery.

Patients and methods: We conducted a population-based, nationwide cohort study using data from the Danish Multidisciplinary Hip Fracture Register (DMHFR). We included 74,771 patients aged 65 and up who underwent surgery from 2005 to 2016 for all types of hip fracture. We calculated net risk of reoperation using Kaplan–Meier method, and, with Cox regression, adjusted hazard ratios (HRs) with a 95% confidence interval (CI) for reoperation due to SSI.

Results: Overall, the 1-year net risk of reoperation due to SSI was 1.6%. The HR was higher for patients undergoing total/hemiarthroplasty surgery versus internal fixation (HR = 1.5; 95%CI 1.3–1.8) and lower for patients with per-/subtrochanteric fracture versus femoral neck fracture (HR = 0.6; CI 0.6–0.7). The risk of reoperation due to SSI decreased over time; HR was 0.7 (CI 0.5–0.8) for 2015–2016 compared with 2005–2006. Risk of reoperation decreased with increasing age; the HR was 0.8 (CI 0.7–1.0) in the more than 85-year-olds compared with 65–74-year-old patients. Charlson Comorbidity Index of ≥ 3 was associated with a higher risk of reoperation due to SSI, HR was 1.3 (CI 1.1–1.6).

Interpretation: The net risk of reoperations due to SSI in our study was lower than previously assumed. We identified several risk factors for increased risk of reoperation due to SSI, most noticeably treatment with arthroplasty vs. internal fixation, as well as younger age, high comorbidity burden, and femoral neck fracture diagnosis.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Risk factors for reoperation due to SSI within 1 year of hip fracture surgery.
Figure 2
Figure 2
Risk factors for reoperation due to SSI within 90 days of hip fracture surgery.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Burge R, Dawson-Hughes B, Solomon D H, Wong J B, King A, Tosteson A. Incidence and economic burden of osteoporosis-related fractures in the United States, 2005–2025. J Bone Miner Res 2007; 22(3): 465-75. - PubMed
    1. Kjørholt K E, Kristensen N R, Prieto-Alhambra D, Johnsen S P, Pedersen A B. Increased risk of mortality after postoperative infection in hip fracture patients. Bone 2019; 127: 563-70. - PubMed
    1. Pollmann C T, Dahl F A, Røtterud J H M, Gjertsen J E, Årøen A. Surgical site infection after hip fracture-mortality and risk factors: an observational cohort study of 1,709 patients. Acta Orthop 2020; 91(3): 347-52. - PMC - PubMed
    1. Kristensen P K, Röck N D, Christensen H C, Pedersen A B. The danish multidisciplinary hip fracture registry 13-year results from a population-based cohort of hip fracture patients. Clin Epidemiol 2020; 12: 9-21. - PMC - PubMed
    1. Dale H, Fenstad AM, Hallan G, Havelin LI, Furnes O, Overgaard S, et al. . Increasing risk of prosthetic joint infection after total hip arthroplasty. Acta Orthop 2012; 83(5): 449-58. - PMC - PubMed