A systematic literature review focusing on how long before surgery concurrent viral or bacterial infections (respiratory and urinary infections) should be treated in hip fracture patients, and if there is evidence for delaying this surgery. A total of 11 databases were examined using the COre, Standard, Ideal (COSI) protocol. Bibliographic searches (no chronological or linguistic restriction) were conducted using, among other methods, the Patient, Intervention, Comparison, Outcome (PICO) template. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for flow diagram and checklist. Final reading of the complete texts was conducted in English, French, and Spanish. Classification of papers was completed within five levels of evidence (LE).Aims
Methods
Hip fracture is a worldwide problem, not only as far as epidemiology is concerned but also regarding economical issues. Surgery is the current standard treatment. However owing to age, and patients co-morbidities complications are common. Surgical site infection is directly related to operative procedure, and surgeons' experience may be very important when making plans for outcome improvement. In this paper we study the role of hip surgeons versus general orthopaedic surgeons in relation to postoperative site infection. Operative hypothesis determines that hip surgeons have less infection rates than general orthopaedic surgeons. Null hypothesis that infection rates are rather the same. In a prospective controlled cohort study 820 patients presenting with a hip fracture were randomizelly operated on by a group of orthopaedic surgeons of the same Hospital Department. Patients were then classified according to surgeons adscription either to a Hip Unit (Group A=215 cases) or not (Group B=605). Variables studied included age, gender, treatment (osteosynthesis or joint replacement), co-morbidities (according to Charlson, s index), and infection rate. Fisher, and Ranksum statistical tests, and simple and multiple logistic regression, for univariate and multivariate, analysis was performed.Introduction
Material and Methods
