Cent Eur J Public Health 2012, 20(4):252-256 | DOI: 10.21101/cejph.a3746

Risk Factors Affecting the Incidence of Infection after Orthopaedic Surgery: The Role of Chemoprophylaxis

Aikaterini Masgala¹, Efstathios Chronopoulos², Georgios Nikolopoulos³, John Sourlas², Stergios Lallos², Emmanuel Brilakis², John Lazarettos², Nikolaos Efstathopoulos²

¹ First Department of Internal Medicine, Konstantopoulio General Hospital, Athens, Greece

² Second University Orthopaedic Department, Athens Medical School, Konstantopoulio General Hospital, Athens, Greece

³ Hellenic Centre of Diseases Prevention and Control, Athens, Greece

The incidence of surgical site infection and urinary tract infection following orthopaedic procedures has diminished in recent years due to modern antimicrobial prophylaxis. We conducted a case-control study (100 cases, 100 controls) in order to evaluate the risk factors associated with infection after orthopaedic procedures. The following risk factors were defined: gender, age, comorbidities [rheumatoid arthritis, diabetes mellitus, obesity (>30 kg/m²), peripheral vessel disease], pre- and post-operative glucose levels, pre-operative and post-operative length of stay (days), duration (days) of urinary catheterization, type of parenteral antibiotic prophylaxis (cefotaxime or vancomycin), time of surgery (elective or scheduled), American Society of Anesthesiologists (ASA) Score (0-3), type of surgery (fracture osteosynthesis, joint replacement, spinal surgery, other), and the type of anesthesia administered (general, epidural, spinal). Urinary tract infection was the most frequent post-surgical infection (71 out of 100 cases) followed by surgical site infection (15 out of 100 cases). Using the multivariable logistic regression model, we found out that only the type of chemoprophylaxis was statistically significant risk factor (p<0.001) associated with post-surgical infection. More specifically, the use of vancomycin instead of cephalosporin is associated with a lower risk of infection.

Keywords: infection, post-surgical, orthopaedics, risk factors

Received: November 28, 2011; Revised: September 17, 2012; Accepted: September 17, 2012; Published: December 1, 2012  Show citation