Journal
BONE & JOINT RESEARCH
Volume 9, Issue 9, Pages 554-562Publisher
BRITISH EDITORIAL SOC BONE & JOINT SURGERY
DOI: 10.1302/2046-3758.99.BJR-2020-0023.R1
Keywords
Hip fracture; Surgical site infection; Epidemiology
Categories
Funding
- Royal College of Surgeons of England
- Dunhill Medical Trust [DMT/RCS605]
- National Institute for Health Research (NIHR) Oxford Biomedical Research Centre
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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 1 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 551 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.
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