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Postoperative UTI linked to deep infection after hip fracture surgery

Issue: November 2012

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MINNEAPOLIS — Investigators from the United Kingdom cited postoperative urinary tract infection as a significant risk factor of deep infection and longer hospital stay after treatment for proximal femoral fracture, according to a study presented here.

“Our conclusion was that aggressive prevention and treatment of [urinary tract infection] UTI should reduce length of stay, associated costs and deep infection rates,” Benjamin J. Ollivere, FRCS, MBBS, MD, said during his presentation at the Orthopaedic Trauma Association Annual Meeting 2012.

Ollivere and colleagues performed a retrospective analysis of prospectively collected data on 9,168 patients with proximal femur fractures treated during an 11-year period. The patients were followed up to death or revision, Ollivere said.

 

Benjamin Ollivere

The investigators found 6.1% of patients had a postoperative UTI and 0.89% developed a deep infection.

“We found a significant association,” Ollivere said.

Of the 561 patients with a UTI, 18 patients developed a deep infection. Of the 8,607 patients without a UTI, 64 patients had a deep infection.

Ollivere added, “Interestingly, 58% [of patients had] the same organism in the urine and the deep tissue taken at revision.”

UTI was also significantly associated with an increased length of hospital stay. The investigators found higher 30-day mortality in patients who did not have a UTI.

“We think this is probably a confounder, because the patients who die early, you do not observe them for long enough [so] they do not develop their UTI later on.” However, they found no significant differences between the postoperative UTI group and those without the condition for 90-day and 1-year mortalities, delay to surgery and age.

Reference:

Ollivere BJ, Kurien T, Morris C, et al. Postoperative urinary tract infection results in higher rates of deep infection in patients with proximal femoral fractures. Paper #37. Presented at the Orthopaedic Trauma Association Annual Meeting 2012. Oct. 3-6. Minneapolis.

Disclosure: Ollivere has no relevant financial disclosures.