# Preoperative Hemoglobin Level Predicts Surgical Site Infections in Trauma Orthopedic Surgery: A Cohort Study

## TL;DR

Low preoperative hemoglobin levels are linked to a higher risk of surgical site infections after trauma orthopedic surgery, suggesting preoperative blood tests could help prevent infections.

## Contribution

This study identifies preoperative hemoglobin levels as a novel predictor of surgical site infections in trauma orthopedic surgery.

## Key findings

- Low preoperative hemoglobin levels were significantly associated with surgical site infections (p=0.019).
- Postoperative blood parameters were not significantly linked to surgical site infections.
- Preoperative hemoglobin assessment can help identify patients at higher risk for infections.

## Abstract

Background: Surgical site infections resulting from trauma orthopedic surgery increase morbidity and mortality rates and generate additional costs for the healthcare system. Preoperative and postoperative blood parameters have been described as risk predictors for surgical site infection in other surgical areas. The purpose of this study was to assess the role of preoperative and postoperative hematological parameters in predicting the risk of surgical site infections in trauma orthopedic surgery.

Methods: Data on patients' demographics were collected from their medical records and the operation reports. Preoperative and postoperative blood samples were collected for a complete blood count assay. The blood cell parameters as predictors of surgical site infection after trauma orthopedic surgery were determined by the Mann–Whitney U test to assess the differences in the median between the dependent and independent variables. p value < 0.05 was considered statistically significant.

Results: Out of the 210 patients who were followed postsurgery, 14 (6.7%) developed surgical site infection following trauma orthopedic surgery. The mean age of the study participants was 33.08 ± 19.23 (Mean ± SD), with a range of 86 to 0.67 years old. Low preoperative hemoglobin level was identified as a predictor of surgical site infection following trauma orthopedic surgery (p=0.019). None of the postoperative blood parameters measured was significantly associated with surgical site infections after trauma orthopedic surgery in Northern Ghana.

Conclusion: In conclusion, our study demonstrates that preoperative hemoglobin level is a useful hematological parameter for predicting surgical site infection following trauma orthopedic surgery. These inexpensive and common hematological parameters could assist in guiding preventive efforts to reduce surgical site infections and improve outcomes for vulnerable patients undergoing trauma orthopedic surgery. Assessing preoperative hemoglobin levels is crucial in identifying patients at increased risk of developing surgical site infections. Preoperative optimization, including incorporating hemoglobin levels into predictive risk models can help to assess these at-risk persons better. Educate patients on the need to optimize their hemoglobin levels before surgery and discuss potential interventions, including iron supplementation or transfusion.