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The factors associated with nosocomial infection in elderly hip fracture patients: gender, age, and comorbidity

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A Correction to this article was published on 13 October 2021

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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.

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Data availability

Data and materials relating to the study were accessed from the case systems at our department.

Code availability

Not applicable.

Change history

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Funding

This study was supported by the National Key Research and Development Project (2019YFC0840705) and the First Class General Financial Grant from the China Postdoctoral Science Foundation (2017M613325).

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Author notes

  1. Yuan Deng and Zhong Zheng contributed equally to this work.

Authors and Affiliations

  1. Department of Orthopedics, Fourth Medical Center, General Hospital of Chinese PLA, Beijing, 100000, China

    Yuan Deng, Pengbin Yin & Peifu Tang

  2. Information Center of Logistics Support Department of Central Military Commission, Beijing, 100000, China

    Zhong Zheng

  3. Department of Orthopedic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150010, China

    Shi Cheng, Yuan Lin & Duanyang Wang

  4. Department of Critical Care Medicine, First Medical Center, General Hospital of Chinese PLA, Beijing, 100000, China

    Zhi Mao

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  1. Yuan Deng
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Contributions

Peifu Tang and Zhi Mao, contributed to the research design, data acquisition, and revising the manuscript critically; Yuan Deng and Zhong Zheng, data acquisition, drafting the paper, and approval of the submitted and final version of the manuscript; Shi Cheng and Yuan Lin, data acquisition, statistical analysis, approval of the submitted and final version of the manuscript; Duanyang Wang and Pengbin Yin, data acquisition and approval of the submitted and final version of the manuscript.

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Correspondence to Zhi Mao or Peifu Tang.

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This study was approved by the ethics committee of the Chinese PLA General Hospital. A written informed consent was obtained from all the patients.

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The authors declare no competing interests.

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The original online version of this article was revised due to a retrospective Open Access cancellation.

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Deng, Y., Zheng, Z., Cheng, S. et al. The factors associated with nosocomial infection in elderly hip fracture patients: gender, age, and comorbidity. International Orthopaedics (SICOT) 45, 3201–3209 (2021). https://doi.org/10.1007/s00264-021-05104-3

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