Paper of the week: Modifiable Factors as Current Smoking, Hypoalbumin, and Elevated Fasting Blood Glucose Level Increased the SSI Risk Following Elderly Hip Fracture Surgery. Ma T, Lu K, Song L, Wang D, Ning S, Chen Z, Wu Z. J Invest Surg. 2019 Mar 19:1-9. doi: 10.1080/08941939.2018.1556364.

Summary by Dr Sreeram Penna

Aim of this retrospective study was to find incidence of infection post hip fracture surgery in elderly population. In addition, researchers were also looking for independent risk factors associated with infection in this cohort. Infections were classified in to superficial and deep infections based on combination of clinical findings of persistent wound discharge, wound dehiscence, gangrene and abscess development, need for surgical intervention and positive cultures. 611 patients were included in the final study. Over all infection incidence was 4.4% (27/611), superficial infection was 3.1% (21/611) and deep infection was 1.3% (6/611). Multivariate analysis showed that body mass index, current smoking, surgical duration of more than 2 hours, preoperative hospital stay more than 7 days, ASA class of III and IV, albumin levels less than 35 gram per liter, and fasting blood glucose more than 110 mg/dl were know to be independent risk factors for development of infection following hip fracture surgery.