# Surgical Site Infection Risk Factors in Hip Arthroplasty for Transcervical Femoral Neck Fractures

## TL;DR

This study found that blood transfusions and certain health conditions increase the risk of surgical site infections after hip replacement surgery for femoral neck fractures.

## Contribution

The study identifies blood transfusion history and comorbidities as novel risk factors for SSIs in THA patients.

## Key findings

- 13.8% of patients who underwent THA developed surgical site infections.
- Blood transfusion history was significantly associated with SSIs (75% of infected patients had transfusions).
- Diabetes, hypertension, and chronic kidney disease were also linked to increased infection risk.

## Abstract

Background

Hip fracture patients often experience surgical site infections (SSIs) as a major infectious complication after undergoing total hip arthroplasty (THA), which can lead to extended hospital stays, increased mortality, and higher healthcare costs. This study aimed to determine the incidence of SSI and identify the risk factors associated with it after THA.

Objective

This study aimed to explore the correlation between blood transfusion along with other factors and the occurrence of SSIs in postoperative patients who underwent THA for transcervical femoral neck fractures.

Methods

We conducted a retrospective analysis by reviewing the medical records of patients aged 60-80 years who underwent surgery for hip fractures at the Unidad Médica de Alta Especialidad Hospital de Traumatología y Ortopedia No. 21 in Monterrey, Mexico, between January 2020 and January 2021. We analyzed potential risk factors such as age, sex, transfusion necessity, preoperative hemoglobin levels, history of diabetes mellitus, arterial hypertension, and end-stage chronic disease. Data are presented as numbers and percentages, and statistical analyses were performed using IBM SPSS Statistics for Windows, Version 28.0 (Released 2021; IBM Corp., Armonk, New York, United States).

Results

The study included 87 patients, of whom 55 (63%) were women with an average age of 73 years. SSIs were identified in 12 (13.8%) patients. Among those with infections, nine (75%) had a history of blood transfusion (p=0.05). Diabetes, hypertension, and chronic kidney disease also increased the risk for infection. There was no association with gender, age, American Society of Anesthesiologists (ASA) risk, and preoperative hemoglobin.

Conclusions

We found a heightened risk of SSI in patients with a history of blood transfusions, emphasizing the need for careful consideration and monitoring during the perioperative period. Additionally, patients with comorbidities such as diabetes, hypertension, and chronic kidney disease were more susceptible to SSI, underscoring the importance of preoperative assessment and targeted preventive measures. Further research and collaboration are needed to refine strategies for mitigating SSI risk factors and optimizing healthcare resource utilization.