Yuan Deng1, Zhong Zheng2, Shi Cheng3, Yuan Lin3, Duanyang Wang3, Pengbin Yin1, Zhi Mao4, Peifu Tang5. 1. Department of Orthopedics, Fourth Medical Center, General Hospital of Chinese PLA, Beijing, 100000, China. 2. Information Center of Logistics Support Department of Central Military Commission, Beijing, 100000, China. 3. Department of Orthopedic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150010, China. 4. Department of Critical Care Medicine, First Medical Center, General Hospital of Chinese PLA, Beijing, 100000, China. maozhi@126.com. 5. Department of Orthopedics, Fourth Medical Center, General Hospital of Chinese PLA, Beijing, 100000, China. pftang301@163.com.
Abstract
PURPOSE: This is a retrospective case-control study to ascertain the factors influencing nosocomial infection (NI) in elderly patients with hip fractures. METHODS: A total of 80,174 patients (≥ 60 years) who suffered hip fractures between 2006 and 2017 were identified through a national inquiry of 94 hospitals. The patients were divided into an NI group and control group according to the occurrence or lack of occurrence of NI within 48 hours after surgery, respectively. Age, gender, hip fracture pattern, whether to operate, surgical treatments, and comorbidities were recorded as variables. RESULTS: A total of 9806 elderly hip fracture patients (60 years) were included, 1977 of whom were patients diagnosed with NI. The control group consisted of randomly drawn cases from the 9806 patients from different hospitals with a rate of one NI patient: four patients without NI. Patient gender, age, and in particular the number of comorbidities were associated with occurrence of NI. Using regression models to predict infection outcomes based on the number of comorbidities had an area under the curve (AUC) of 0.714, while using the Charlson comorbidity index (CCI) yielded a smaller value of 0.694. The most common comorbidities of this elderly cohort were chronic respiratory disease, hypertension, diabetes mellitus, cerebrovascular disease, and coronary heart disease. CONCLUSIONS: Older age, male gender, and greater number of comorbidities were found to be associated with the occurrence of NI. In particular, the number of comorbidities was the most accurate predictor of NI occurrence, and when used to build a regression model, it had greater predictive capability than CCI to predict NI in elderly hip fracture patients. Additionally, the common diseases of the elderly should be primarily considered when investigating the relationship between comorbidities and NI in older patients.
PURPOSE: This is a retrospective case-control study to ascertain the factors influencing nosocomial infection (NI) in elderly patients with hip fractures. METHODS: A total of 80,174 patients (≥ 60 years) who suffered hip fractures between 2006 and 2017 were identified through a national inquiry of 94 hospitals. The patients were divided into an NI group and control group according to the occurrence or lack of occurrence of NI within 48 hours after surgery, respectively. Age, gender, hip fracture pattern, whether to operate, surgical treatments, and comorbidities were recorded as variables. RESULTS: A total of 9806 elderly hip fracture patients (60 years) were included, 1977 of whom were patients diagnosed with NI. The control group consisted of randomly drawn cases from the 9806 patients from different hospitals with a rate of one NI patient: four patients without NI. Patient gender, age, and in particular the number of comorbidities were associated with occurrence of NI. Using regression models to predict infection outcomes based on the number of comorbidities had an area under the curve (AUC) of 0.714, while using the Charlson comorbidity index (CCI) yielded a smaller value of 0.694. The most common comorbidities of this elderly cohort were chronic respiratory disease, hypertension, diabetes mellitus, cerebrovascular disease, and coronary heart disease. CONCLUSIONS: Older age, male gender, and greater number of comorbidities were found to be associated with the occurrence of NI. In particular, the number of comorbidities was the most accurate predictor of NI occurrence, and when used to build a regression model, it had greater predictive capability than CCI to predict NI in elderly hip fracture patients. Additionally, the common diseases of the elderly should be primarily considered when investigating the relationship between comorbidities and NI in older patients.
Authors: Patrick Haentjens; Jay Magaziner; Cathleen S Colón-Emeric; Dirk Vanderschueren; Koen Milisen; Brigitte Velkeniers; Steven Boonen Journal: Ann Intern Med Date: 2010-03-16 Impact factor: 25.391
Authors: K J Sheehan; L Williamson; J Alexander; C Filliter; B Sobolev; P Guy; L M Bearne; C Sackley Journal: Age Ageing Date: 2018-09-01 Impact factor: 10.668
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