TY - JOUR AU - Pollmann, Christian T AU - Dahl, Fredrik A AU - Røtterud, Jan Harald M AU - Gjertsen , Jan-Erik AU - Årøen, Asbjørn PY - 2020/01/24 Y2 - 2024/03/28 TI - Surgical site infection after hip fracture – mortality and risk factors: an observational cohort study of 1,709 patients JF - Acta Orthopaedica JA - ActaO VL - 91 IS - 3 SE - Articles DO - 10.1080/17453674.2020.1717841 UR - https://actaorthop.org/actao/article/view/490 SP - 347–352 AB - <p><strong>Background and purpose —</strong> Surgical site infection (SSI)&nbsp;is a devastating complication of hip fracture surgery. We&nbsp;studied the contribution of early deep SSI to mortality after&nbsp;hip fracture surgery and the risk factors for deep SSI with&nbsp;emphasis on the duration of surgery.</p><p><strong>Patients and methods —</strong> 1,709 patients (884 hemiarthroplasties, 825 sliding hip screws), operated from 2012&nbsp;to 2015 at a single center were included. Data were obtained&nbsp;from the Norwegian Hip Fracture Register, the electronic&nbsp;hospital records, the Norwegian Surveillance System for&nbsp;Antibiotic Use and Hospital-Acquired Infections, and the&nbsp;Central Population Register.</p><p><strong>Results —</strong> The rate of early (≤ 30 days) deep SSI was&nbsp;2.2% (38/1,709). Additionally, for hemiarthroplasties 7&nbsp;delayed (&gt; 30 days, ≤ 1 year) deep SSIs were reported. In&nbsp;patients with early deep SSI 90-day mortality tripled (42%&nbsp;vs. 14%, p &lt; 0.001) and 1-year mortality doubled (55%&nbsp;vs. 24%, p &lt; 0.001). In multivariable analysis, early deep&nbsp;SSI was an independent risk factor for mortality (RR 2.4&nbsp;for 90-day mortality, 1.8 for 1-year mortality, p &lt; 0.001).&nbsp;In univariable analysis, significant risk factors for early and&nbsp;delayed deep SSI were cognitive impairment, an intraoperative complication, and increasing duration of surgery. However, in the multivariable analysis, duration of surgery was&nbsp;no longer a significant risk factor.</p><p><strong>Interpretation —</strong> Early deep SSI is an independent risk&nbsp;factor for 90-day and 1-year mortality after hip fracture surgery. After controlling for observed confounding, the association between duration of surgery and early and delayed&nbsp;deep SSI was not statistically significant.</p> ER -