Open AccessSurgical site infection after hip fracture surgery
Author(s) -
James Masters,
David Metcalfe,
Joon Soo Ha,
Andrew Judge,
Matthew L. Costa
Publication year - 2020
Publication title -
bone and joint research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.639
H-Index - 31
ISSN - 2046-3758
DOI - 10.1302/2046-3758.99.bjr-2020-0023.r1
Subject(s) - medicine , hip fracture , confidence interval , incidence (geometry) , surgical site infection , retrospective cohort study , surgery , cohort study , meta analysis , odds ratio , osteoporosis , physics , optics
Aims This study explores the reported rate of surgical site infection (SSI) after hip fracture surgery in published studies concerning patients treated in the UK.Methods Studies were included if they reported on SSI after any type of surgical treatment for hip fracture. Each study required a minimum of 30 days follow-up and 100 patients. Meta-analysis was undertaken using a random effects model. Heterogeneity was expressed using the I 2 statistic. Risk of bias was assessed using a modified Newcastle-Ottawa Scale (NOS) system.Results There were 20 studies reporting data from 88,615 patients. Most were retrospective cohort studies from single centres. The pooled incidence was 2.1% (95% confidence interval (CI) 1.54% to 2.62%) across ‘all types’ of hip fracture surgery. When analyzed by operation type, the SSI incidences were: hemiarthroplasty 2.87% (95% CI 1.99% to 3.75%) and sliding hip screw 1.35% (95% CI 0.78% to 1.93%). There was considerable variation in definition of infection used, as well as considerable risk of bias, particularly as few studies actively screened participants for SSI.Conclusion Synthesis of published estimates of infection yield a rate higher than that seen in national surveillance procedures. Biases noted in all studies would trend towards an underestimate, largely due to inadequate follow-up.