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
. 2023 Jan 3;5(1):1.
doi: 10.1186/s42836-022-00155-2.

Incidence and risk factors for surgical site infection (SSI) after primary hip hemiarthroplasty: an analysis of the ACS-NSQIP hip fracture procedure targeted database

Arjun Gupta  1 , John Shin  1 , Dylan Oliver  1 , Michael Vives  1 , Sheldon Lin  2
Affiliations

Incidence and risk factors for surgical site infection (SSI) after primary hip hemiarthroplasty: an analysis of the ACS-NSQIP hip fracture procedure targeted database

Arjun Gupta et al. Arthroplasty. .

Abstract

Introduction: Primary hip hemiarthroplasty (HHA) is frequently utilized to treat geriatric hip fractures, which are associated with significantly higher morbidity and mortality. While not particularly common, surgical site infection (SSI) is a major complication that frequently requires revision surgery in a frail population. The objective of this study was to determine the incidence of and risk factors for SSI after HHA in hip fracture patients.

Materials and methods: This retrospective cohort study was performed using the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database. Geriatric patients (65+) who underwent HHA for non-pathologic, traumatic hip fractures between 2016-2017 were included. Demographic variables, comorbidities, operative variables, and complications were compared between "SSI" and "non-SSI" groups. Multivariate regression identified independent risk factors for postoperative SSI. Significance was set at P = 0.05.

Results: A total of 6169 patients were included. The overall incidence of SSI was 1.3%. SSI was significantly associated with body mass index (BMI), preoperative functional status, congestive heart failure, chronic corticosteroid use, intraoperative time, sepsis, wound dehiscence, readmission within 30-days, and reoperation. On multivariate analysis, chronic steroid use (OR: 2.30, 95% CI: 1.13-4.70), BMI ≥ 35 kg/m2 (OR: 3.59, 95% CI: 1.57-8.18), and intraoperative time ≥120 mins (OR: 2.15, 95% CI: 1.08-4.27) were found to be independent risk factors.

Conclusions: Postoperative SSI is a serious complication that is responsible for prolonged hospital stays, increased mortality, and greater healthcare costs. Here, we identified multiple risk factors for SSI after primary HHA in the US elderly population.

Keywords: Femoral neck fracture; Geriatric; Hip hemiarthroplasty; NSQIP; Surgical site infection; Trauma.

PubMed Disclaimer

Conflict of interest statement

M. V. serves on the Editorial Boards of Journal of Spinal Cord Medicine and Spine Journal, as well as the Board of NASS. S. L. is a paid speaker for Treace, unpaid consultant for Bioventus, and founder of Cre Osso. S. L. serves on the Editorial Board of Foot and Ankle International, as well as the Board of AOFAS.

References

    1. Sathiyakumar V, Greenberg SE, Molina CS, Thakore RV, Obremskey WT, Sethi MK. Hip fractures are risky business: an analysis of the NSQIP data. Injury. 2015;46(4):703. doi: 10.1016/j.injury.2014.10.051. - DOI - PubMed
    1. Cheng SY, Levy AR, Lefaivre KA, Guy P, Kuramoto L, Sobolev B. Geographic trends in incidence of hip fractures: a comprehensive literature review. Osteoporos Int. 2011;22(10):2575. doi: 10.1007/s00198-011-1596-z. - DOI - PubMed
    1. Zi-Sheng A, You-Shui G, Zhi-Zhen J, Ting Y, Chang-Qing Z. Hemiarthroplasty vs primary total hip arthroplasty for displaced fractures of the femoral neck in the elderly: a meta-analysis. J Arthroplasty. 2012;27(4):583. doi: 10.1016/j.arth.2011.07.009. - DOI - PubMed
    1. Woon CYL, Moretti VM, Schwartz BE, Goldberg BA. Total hip arthroplasty and hemiarthroplasty: US national trends in the treatment of femoral neck fractures. Am J Orthop (Belle Mead NJ) 2017;46(6):E474. - PubMed
    1. Suarez JC, Arguelles W, Saxena A, Rivera P, Parris D, Veledar E. Hemiarthroplasty vs total hip arthroplasty for femoral neck fractures: 2010-2017 trends in complication rates. J Arthroplasty. 2020;35(6, Supplement):S262. doi: 10.1016/j.arth.2020.02.040. - DOI - PubMed

LinkOut - more resources