Clostridium difficile colitis following geriatric hip fracture surgery: incidence, trends, and risk factors from 45,910 patients

被引:1
作者
Voyvodic, Lucas C. C. [1 ]
Rodriguez, Ariel N. N. [1 ]
Gordon, Adam M. M. [1 ]
Golub, Ivan J. J. [1 ]
Miller, Chaim [1 ]
Kang, Kevin K. K. [1 ]
机构
[1] Maimonides Hosp, Dept Orthopaed Surg, 927 49th St, Brooklyn, NY 11219 USA
基金
英国科研创新办公室;
关键词
Hip fracture; NSQIP; Geriatrics; Clostridium difficile colitis; Complications; INTERNAL-FIXATION; INFECTION; ARTHROPLASTY; DIARRHEA; IMPACT;
D O I
10.1007/s00590-023-03523-z
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
PurposeClostridium difficile colitis is a serious complication in elderly patients undergoing surgery. The objectives of this study were: (1) to use a nationwide sample of patients to report the incidence and timing of C. difficile colitis in geriatric patients who underwent surgery for hip fractures, (2) to identify preoperative factors associated with developing C. difficile colitis and mortality.MethodsThis was a retrospective evaluation of the 2016-2019 ACS Targeted Hip Fracture database merged with the ACS-NSQIP database. Patients undergoing surgery for hip fracture were included. Outcomes studied were incidence, preoperative, and postoperative risk factors for occurrence of C. difficile infection and mortality. Chi-squared tests were used to compare demographics between the patients infected (study) and not infected (control). Logistic regression models were utilized to compute the odds ratios (OR) testing for the association of independent factors on developing C. difficile infection postoperatively and mortality. A statistical threshold was set at p < 0.008.ResultsThe incidence of C. difficile infection within 30 days of hip fracture surgery was 0.81%. Fifty percent of infections were diagnosed within 9 days postoperatively. Preoperative and hospital-associated factors associated with development of C. difficile infection were >= 2 days until operation (OR 1.88 [95% CI 1.39-2.55], p < 0.001) and dependent functional status (OR 1.43 [95% CI 1.14-1.79], p = 0.002). After adjusting for multiple comorbidities, increased age, male sex, COPD, CHF, dependent functional status, and C. difficile infection were associated with increased mortality within 30 days of surgery (all p < 0.001).ConclusionClostridium difficile colitis is a serious infection after hip fracture surgery in geriatric patients with an incidence of about 1%. Patients at increased risk should be targeted with preventative measures to prevent the morbidity from this complication.
引用
收藏
页码:3043 / 3050
页数:8
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