Postoperative sepsis and septic shock after hip fracture surgery

•After hip fracture surgery, the incidence of sepsis was 1.0%, and the incidence of septic shock was 0.6%.•Patients with sepsis and septic shock had 30-day mortality rates of 16.2% and 40.8%, respectively.•Urinary tract infections, pneumonia, and surgical site infections preceded the majority of cases of sepsis and septic shock.•Prevention, early identification, and treatment of sepsis and septic shock are paramount to lowering mortality after hip fracture surgery. There is a paucity of research in the rates for sepsis and septic shock in the hip fracture population specifically, despite marked clinical and prognostic differences between these conditions. The purpose of this study was to determine the incidence, risk factors, and mortality rates for sepsis and septic shock as well as evaluate potential infectious causes in the surgical hip fracture population. The ACS-NSQIP (2015–2019) was queried for patients who underwent hip fracture surgery. A backward elimination multivariate regression model was used to identify risk factors for sepsis and septic shock. Multivariate regression that controlled for preoperative variables and comorbidities was used to calculate the odds of 30-day mortality. Of 86,438 patients included, 871 (1.0%) developed sepsis and 490 (0.6%) developed septic shock. Risk factors for both postoperative sepsis and septic shock were male gender, DM, COPD, dependent functional status, ASA class ≥3, anemia, and hypoalbuminemia. Unique risk factors for septic shock were CHF and ventilator dependence. The 30-day mortality rate was 4.8% in aseptic patients, 16.2% in patients with sepsis, and 40.8% in patients who developed septic shock (p