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Thickness of the Subcutaneous Fat as a Risk Factor for Surgical Site Infection Following Fragility Hip Fracture Surgery

INTRODUCTION: Surgical site infection (SSI) following fragility hip fracture (FHF) surgery is associated with increased morbidity and mortality. SIGNIFICANCE: Prediction of patients at risk for SSI is fundamental. We aimed to determine whether subcutaneous radiographic fat measurement (SRM) is assoc...

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Detalles Bibliográficos
Autores principales: Frenkel Rutenberg, Tal, Markman, Rotem, Rutenberg, Ran, Daglan, Efrat, Rubin, Tomer, Shemesh, Shai
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8874187/
https://www.ncbi.nlm.nih.gov/pubmed/35223132
http://dx.doi.org/10.1177/21514593221080272
Descripción
Sumario:INTRODUCTION: Surgical site infection (SSI) following fragility hip fracture (FHF) surgery is associated with increased morbidity and mortality. SIGNIFICANCE: Prediction of patients at risk for SSI is fundamental. We aimed to determine whether subcutaneous radiographic fat measurement (SRM) is associated with increased SSI risk. METHODS: A retrospective case-control comparison of SRMs at 3 locations around the hip. Patients diagnosed with SSI in the first post-operative year were matched with age, gender, surgical year, Charlsons’ co-morbidity index score, and surgical type controls, not diagnosed with SSI, at a 1:2 ratio. Measurements included the distance between (1) the sourcil to skin surface (SS), (2) the tip of the greater trochanter to skin surface (TGTS), and (3) the most prominent lateral aspect of the greater trochanter to skin surface. RESULTS: 1430 patients were operated during the study period, of whom 45 patients presented with a diagnosis of SSI and compared to 90 controls. Infections occurred 27.4 ( ± 24.8) days following surgery. SRM significantly differed between groups, and all were higher in the study group; SS, 86.8 ± 25.5 cm vs 74.2 ± 15.3 cm; TGTS, 59.8 ± 26.3 cm vs 47.0 ± 15.8 cm; and LGTS, 45.4 ± 25.1 cm vs 33.2 ± 15.1 cm (P = .003, .004, and .004, respectively). Intraclass correlation coefficients (intra-rater) were high for all measurements (.999 for all). Intraclass correlation coefficients (inter-rater) for SS, TGTS and LGTS were high, .749 (.663.815), .792 (.719.847) and .817 (.751.866), respectively. CONCLUSIONS: SRMs were found to be a valid and reproducible tool for predicting high risk of SSI in geriatric patients sustaining FHFs. LEVEL OF EVIDENCE: III.