DOS 2018

DOS Kongressen 2018 · 63 Increasing risk of post-surgery infections among hip fracture patients: A nationwide study 2005-2016 Kaja E. Kjørholt, Søren P. Johnsen , Nickolaj R. Kristensen , Daniel Prieto-Alhambra , Alma B. Pedersen Department of Clinical Epidemiology , Aarhus University Hospital; Center for Clinical Health Services Research, Department of Clinical Medicine, Aalborg University ; Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences (NDORMS), University of Oxford Background: Post-surgery infections is a leading cause of death among hip fracture patients, however, data on recent time trends in the risk of infections is lacking. Purpose / Aim of Study: We aimed to examine trends in the risk of infections following hip fracture surgery, including hospital- treated infections, as well as community-based ones, in Denmark from 2005 to 2016. Materials and Methods: We conducted a nationwide cohort study based on individual-level record linkage of data from Danish nationwide registries. We calculated cumulative incidence considering death as competing risk and, based on the pseudo-observation method, risk ratios (RRs) with 95% confidence in- terval (CI).using the period 2005-2006 as a reference. RRs were adjusted or stratified by age, sex and comorbidity measured with Charlson Comorbidity in- dex (CCI). Findings / Results: A total of 74,771 patients aged 65 years or older with first time hip fracture surgery were included. The 30 days cumulative incidence of all hospital- treated infections increased from 10.8 % (95 % CI: 10.2-11.3) in 2005-2006 to 14.3% (95 % CI: 13.7- 15.0) in 2015-2016 [adjusted RR: 1.32 (95% CI: 1.23-1.42)]. The risk of infectious hospitalization increased ir- respective of patient’s age, sex and CCI score. The 30 days cumulative incidence of redeeming community-based antibiotic prescriptions increased from 17.5 % (95 % CI: 16.8-18.2) in 2005- 2006 to 27.1 % (95 % CI: 26.3-27.9) in 2015-2016 [adjusted RR: 1.56 (95 % CI: 1.49-1.64)]. Conclusions: We found an increased risk of infection following hip fracture sur- gery during the 12- year study period. Given the high mortality following infec- tions in the elderly, further research is needed to identify patients at increased risk to target preventive treatment and potentially reduce complications and mortality in hip fracture patients. 6.

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