TITLE:
Risk Factors for Surgical Site Infection after Hip Arthroplasty: A Multicentric Study
AUTHORS:
Gabriel B. Tofani, Gustavo P. Irffi, Lucas F. Silva, Cynthia C. M. da Silva, Bráulio R. G. M. Couto, Gilberto D. Miranda, Carlos E. F. Starling
KEYWORDS:
Surgical Site Infection, Hip Arthroplasty, Hip Replacement, Risk Factors
JOURNAL NAME:
Surgical Science,
Vol.7 No.2,
February
14,
2016
ABSTRACT: The objective of this study is to answer three main questions: What is
the risk of wound infection for patients undergoing hip arthroplasty? What are
the main etiologicagents of surgical site infection (SSI)? What are the risk
factors most associated with surgical site infection? Method: This was a multicentric,
retrospective cohort study which analyzed data collected in five general
hospitals in Belo Horizonte, Brazil, between the period of January 2009 and
December 2013. The continuous parameters studied were age, length of hospital
stay before surgery, duration of surgery, number of professionals at surgery
and number of hospital admissions. Categorical variables were surgical wound classification
(clean, clean contaminated, contaminated, dirty/infected), American Society of
Anesthesiologists (ASA) score (I, II, III, IV, V), type of surgery (elective, emergency),
general anesthesia (yes, no), prophylactic antibiotic (yes, no), trauma surgery
(yes, no) and Nosocomial Infections Surveillance (NNIS) risk index (IRIC = 0,
1, 2, 3). Results: Estimated SSI risk was 3.2% (95% C.I. = 2.6% to 4.1%) and
risk of osteomyelitis was 0.6% (95% C.I. = 0.4% to 1.1%). ASA score > 2,
general anesthesia, length of hospital stay before surgery higher than four
days, more than two professionals at surgical field and duration of surgery
higher than five hours were risk factors for SSI after hip prosthesis (p p > 0.100). Each modified
NNIS risk category increased the chance of a patient being infected by almost
three times, when compared with the previous category (OR = 2.82; p = 0.011).