Literature DB >> 25280863

Should hip fractures be operated upon only by specialist hip unit surgeons in order to lower rates of surgical site infection?

Enrique Guerado1, Juan R Cano, Encarnacion Cruz, María Luisa Bertrand, Miguel Hirschfeld, Nicolas Benitez-Parejo.   

Abstract

PURPOSE: The purpose of this study was to compare outcomes of hip fractures treated by orthopaedic surgeons, performed by specialist vs. non-specialist surgeons. The rate of surgical site infection (SSI) obtained is taken as the main variable.
METHODS: This was a prospective controlled cohort study of 814 patients presenting with hip fractures, operated on by a group of orthopaedic surgeons within the same hospital department. Patients were classified according to whether the surgeons belonged to a specialist hip unit (group A = 212 cases) or not (group B = 602 cases).
RESULTS: Multivariate logistic regression showed that there was no relation between gender, SSI, Charlson's index, preoperative period, surgical technique or study groups (A or B). Only age was a determinant factor (rank-sum test p = 0.03; OR 95% CI = 1.07, p = 0.005).
CONCLUSIONS: Since there were no differences in the SSI outcome between surgeons working in a specialist hip unit and the general orthopaedic surgeons, delaying operative treatment for hip fractures to enable treatment in such a unit or creating a new unit of this type is not necessary. In this respect, the only significant variable is the patient's age.

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Year:  2014        PMID: 25280863     DOI: 10.1007/s00264-014-2543-3

Source DB:  PubMed          Journal:  Int Orthop        ISSN: 0341-2695            Impact factor:   3.075


  18 in total

Review 1.  Effect of early surgery after hip fracture on mortality and complications: systematic review and meta-analysis.

Authors:  Nicole Simunovic; P J Devereaux; Sheila Sprague; Gordon H Guyatt; Emil Schemitsch; Justin Debeer; Mohit Bhandari
Journal:  CMAJ       Date:  2010-09-13       Impact factor: 8.262

Review 2.  A comparison of goodness-of-fit tests for the logistic regression model.

Authors:  D W Hosmer; T Hosmer; S Le Cessie; S Lemeshow
Journal:  Stat Med       Date:  1997-05-15       Impact factor: 2.373

3.  A new method of classifying prognostic comorbidity in longitudinal studies: development and validation.

Authors:  M E Charlson; P Pompei; K L Ales; C R MacKenzie
Journal:  J Chronic Dis       Date:  1987

Review 4.  Epidemiology of hip fractures.

Authors:  P Kannus; J Parkkari; H Sievänen; A Heinonen; I Vuori; M Järvinen
Journal:  Bone       Date:  1996-01       Impact factor: 4.398

5.  Age as a risk factor of nosocomial infection after hip fracture surgery.

Authors:  Encarnacion Cruz; Juan Ramon Cano; Nicolás Benitez-Parejo; Francisco Rivas-Ruiz; Emilio Perea-Milla; Enrique Guerado
Journal:  Hip Int       Date:  2010-05-27       Impact factor: 2.135

6.  Role of mental disorders in nosocomial infections after hip fracture treatment.

Authors:  Enrique Guerado; Juan Ramon Cano; Encarnacion Cruz; Nicolás Benitez-Parejo; Emilio Perea-Milla
Journal:  Interdiscip Perspect Infect Dis       Date:  2010-06-10

7.  Early infection after hip fracture surgery: risk factors, costs and outcome.

Authors:  C Edwards; A Counsell; C Boulton; C G Moran
Journal:  J Bone Joint Surg Br       Date:  2008-06

8.  Risk of mortality following hip fracture in Japan.

Authors:  Yukiharu Hasegawa; Sadao Suzuki; Hans Wingstrand
Journal:  J Orthop Sci       Date:  2007-03-30       Impact factor: 1.601

9.  Predictors of early mortality after hip fracture surgery.

Authors:  Muhammad Asim Khan; Fahad Siddique Hossain; Iftikhar Ahmed; Nagarajan Muthukumar; Amr Mohsen
Journal:  Int Orthop       Date:  2013-08-28       Impact factor: 3.075

10.  Influence of the timing of surgery on mortality and activity of hip fracture in elderly patients.

Authors:  Toshiro Yonezawa; Ken Yamazaki; Takashi Atsumi; Shu Obara
Journal:  J Orthop Sci       Date:  2009-10-03       Impact factor: 1.601

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  4 in total

1.  Reply to comments by Li et al.: "Do the specialist hip unit surgeons have no significant influence on reducing rates of surgical site infection?".

Authors:  Enrique Guerado; Juan Cano; Encarnacion Cruz; Maria Bertrand; Miguel Hirschfeld; Nicolas Benitez-Parejo
Journal:  Int Orthop       Date:  2014-12-31       Impact factor: 3.075

2.  Do specialist hip unit surgeons have any significant influence on reducing rates of surgical site infection?

Authors:  Xiao-yang Li; Hui Li; Jie Bu; Tao Xiao
Journal:  Int Orthop       Date:  2014-11-26       Impact factor: 3.075

3.  Irrigation and debridement for periprosthetic infections of the hip and factors determining outcome.

Authors:  Georgios K Triantafyllopoulos; Lazaros A Poultsides; Vasileios I Sakellariou; Wei Zhang; Peter K Sculco; Yan Ma; Thomas P Sculco
Journal:  Int Orthop       Date:  2015-03-31       Impact factor: 3.075

4.  Pre-fracture quality of life predicts 1-year survival in elderly patients with hip fracture-development of a new scoring system.

Authors:  C Bliemel; R Sielski; B Doering; R Dodel; M Balzer-Geldsetzer; S Ruchholtz; B Buecking
Journal:  Osteoporos Int       Date:  2016-01-05       Impact factor: 4.507

  4 in total

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