Surgical site infection following traumatic orthopaedic surgeries in geriatric patients: Incidence and prognostic risk factors

Geriatric population is increasing rapidly worldwide, and fragility fracture and complication following orthopaedic surgery in elderly people have now become major challenges for surgeons. Further studies are required to identify potentially modifiable factors associated with surgical site infection (SSI) in geriatric patients. This retrospective, multicenter study was conducted at four level I hospitals in China. During the 31‐month study period, a total of 2341 patients (65 years or older) underwent orthopaedic surgery and complete data were recorded from September 2015 to April 2018. Demographics information, medications and additional comorbidities, surgery‐related variables, and laboratory indexes were extracted and analysed. Receiver‐operating characteristic analysis was performed to detect the optimum threshold of continuous variables. Independent risk factors of SSI were identified by univariate and multivariate analyses. Finally, 63 patients suffered from wound infection within the follow‐up period, indicating a 2.7% incidence rate of SSI. Statistical results showed that open injury (odds ratio [OR], 9.5; 95% confidence interval [CI], 5.4‐16.7), American Society of Anesthesiologists classified III‐IV score (OR, 2.2; 95% CI, 1.3‐3.8), surgical duration of >132 minutes (OR, 2.9; 95% CI, 1.1‐5.0), serum albumin (ALB) of 118 mg/dL (OR, 3.1; 95% CI, 1.1‐5.3) were independent risk factors of postoperative SSI. With the application of sensitive and modifiable variables such as surgical duration and the levels of ALB and GLU, more geriatric patients with sub‐high risk of postoperative SSI could be identified.