Incidence and risk factors associated with surgical site infection in acetabular fracture patients: An experience from north India

Nearly 5–7% of patients undergoing surgical management of acetabular fractures develop surgical site infection (SSI) which is one of the most important factors affecting the hospital stay, success of procedure and overall patient satisfaction. Systematic studies to identify the risk factors and their control could help to reduce the surgical site infection rate considerably. The present study assessed the incidence and risk factors related with SSI in patients undergoing surgical management of acetabular fractures at our center. This retrospective record review included a total of 228 adult acetabular fracture patients (≥18 years) who were managed surgically. Demographic and clinical profile of the patients was noted and cases developing SSI. Univariate and multivariate association of different demographic and clinical factors was done to identify factors significantly associated with SSI. Univariate analysis was done using chi-square test. Multivariate assessment was done using binary logistic regression. Mean age of patients was 36.40 ± 14.18 years. Majority of patients were males (83.8 %). Incidence of SSI was 6.1 %. On univariate analysis, age ≥40 years, occupation service/business, fall from height, BMI >25 kg/m2, presence of associated injury, ≥48 h gap between injury and surgery, smoking and use of Kocher-Langenbeck approach for surgery were found to be significantly associated with an increased risk of SSI. However, on multivariate analysis only age >40 years (OR = 3.72; 95 % CI = 1.00–3.75; p = 0.049) and BMI>25.0 kg/m2 (OR = 0.20; 95 % CI = 0.05–0.85; p = 0.029) were the significant predictors of SSI. This study identified that surgical site infection rates show a secular stagnating trend. There were almost no modifiable risk factors that could reduce this incidence, however, a strict post-operative care in patients with age >40 years and BMI>25 kg/m2 could help to change the direction of these trends.