Hand infection patients presenting to an orthopaedic unit: An audit of incidence and demographics at a rural hospital

Objective Hand infections are a common presentation to health services in the N orthern T erritory; however, little is known about these patients. This study aims to identify incidence, treatment and co‐morbidities of hand infection patients and to pinpoint factors associated with poor outcome. Design A retrospective study of all patients presenting to A lice S prings H ospital with a hand infection during 2012. Setting Orthopaedic Unit at A lice S prings H ospital. Participants All patients admitted with a hand infection were included. Main outcome measures Admission duration, duration waited before first presentation, re‐admission rate, duration of re‐admission and rate of methicillin‐resistant S taphylococcus aureus . Results One hundred fourteen cases of hand infections were admitted to A lice S prings H ospital during 2012, of which 87 (76%) were in I ndigenous patients. I ndigenous patients ( P  = 0.001) and older patients ( P  = 0.038) had significantly longer admissions. I ndigenous patients were 9.52 times ( P  = 0.038) more likely to be re‐admitted than non‐Indigenous patients. The rate of methicillin‐resistant S taphylococcus aureus was 24.6%, and this was associated with smoking ( P  = 0.049) and substance abuse ( P  = 0.036). Formal follow‐up was not related to indirect measures of hand infection severity, such as admission duration or re‐admissions. Conclusion Hand infections are a common presentation to A lice S prings H ospital. Indigenous people are admitted 2.38 times longer after adjusting for age and alcohol abuse. They have a more than ninefold chance of being re‐admitted to hospital than non‐Indigenous people following a hand infection.