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Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue 6, 770-777.
doi: 10.1302/0301-620X.90B6.20194  
Copyright © 2008 by British Editorial Society of Bone and Joint Surgery
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Early infection after hip fracture surgery

RISK FACTORS, COSTS AND OUTCOME

C. Edwards, MRCS(Ed), PhD, Specialist Registrar (Tr & Orth)1; A. Counsell, BMedSci, MRCS(Ed), FTSTA (ST2), Trauma & Orthopaedics2; C. Boulton, Audit Coordinator1; and C. G. Moran, MD, FRCS(Ed), Consultant Trauma & Orthopaedic Surgeon1

1 Department of Orthopaedics and Trauma, University Hospital, Nottingham, Nottingham NG7 2UH, UK.
2 Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK.

Correspondence should be sent to Professor C. G. Moran; e-mail: Anne.Hay{at}nuh.nhs.uk

Prospective data on hip fracture from 3686 patients at a United Kingdom teaching hospital were analysed to investigate the risk factors, financial costs and outcomes associated with deep or superficial wound infections after hip fracture surgery.

In 1.2% (41) of patients a deep wound infection developed, and 1.1% (39) had a superficial wound infection. A total of 57 of 80 infections (71.3%) were due to Staphylococcus aureus and 39 (48.8%) were due to MRSA.

No statistically significant pre-operative risk factors were detected. Length of stay, cost of treatment and pre-discharge mortality all significantly increased with deep wound infection. The one-year mortality was 30%, and this increased to 50% in those who developed an infection (p < 0.001). A deep infection resulted in doubled operative costs, tripled investigation costs and quadrupled ward costs.

MRSA infection increased costs, length of stay, and pre-discharge mortality compared with non-MRSA infection.




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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General