Related risk factors of perioperative infection in elderly patients with hip fractures

WANG Tao; ZHU Yangjun; ZHANG Kun

doi:10.3969/j.issn.1674-666X.2016.01.002

Abstract：Objective To investigate the risk factors of perioperative infection in elderly patients with hip fractures. Methods A total of 221 elderly patients with hip fractures were treated in Xi'an Red Cross Hospital Affiliated to College of Medicine, Xi'an Jiaotong University and met the selection criteria. Their clinical data were collected. Infection rate and infection types were recorded, relations between infection and factors such as fracture type, surgical procedure, estimate blood loss, time in bed, psychological condition and pain degree of patient were analyzed. Results There were 17 cases of infection, with the overall infection rate of 7.7% (17/221). Pulmonary infection accounted for an absolute majority (7/17), pressure ulcer, urological infection and surgical site infection were as follows. For those who combined with chronic comorbidities, infection rate of patients with respiratory disease was the highest (12%), next, diabetes (6%). For different surgical procedures, infection rate in total hip replacement was the lowest (4%), while the rate in hollow screw fixation was the highest (13%). When the estimate bleeding amount was above 800 mL, the rate of infection increased significantly (18%). With the prolonged time in bed after the surgery, infection rate also presented increasing tendency. There were different infection rates in patients with different anxiety conditions and different pain degrees, with 14% in patients with severe anxiety and 15% in patients with severe pain. Conclusions For elderly patients with hip fracture, pulmonary infection is the main type of infection during perioperative period, followed by pressure sore. High infection rate could be seen in patients with preoperative comorbidities such as primary respiratory diseases. The related factors also include surgical procedures, estimate blood loss, time in bed, meanwhile, anxiety and pain are important risk factors for perioperative infection.