Risk factors of surgical site infections in hip hemiarthroplasty: a single-institution experience over nine years

<p><b>INTRODUCTION</b>This study aims to describe the factors associated with surgical site infection (SSI) in elderly patients who underwent hip hemiarthroplasty following a hip fracture, in a single institution over a nine-year period.</p><p><b>METHODS</b>All patients who underwent hip hemiarthroplasty between 1 January 2004 and 31 December 2012 in our hospital were included in the present study. The detection of SSI was carried out by a trained, independent infection control nurse using the United States Centers for Disease Control and Prevention criteria. Demographic and clinical data were collected retrospectively. Demographics and clinical factors were analysed for potential associations with SSI.</p><p><b>RESULTS</b>Among the 1,320 patients who met the study inclusion criteria, a total 57 SSIs were documented, giving an infection rate of 4.3%. Patients who waited for more than one week for surgery had a statistically significantly higher risk of SSI (odds ratio 3.030, 95% confidence interval 1.075-8.545, p = 0.036). The presence of SSI was also significantly associated with increased length of hospital stay (p < 0.001). The two main microorganisms detected were methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa, which accounted for 50.9% and 26.3% of the SSIs, respectively.</p><p><b>CONCLUSION</b>We concluded that the number of days from admission to surgery is a main risk factor for the development of SSI. Steps should, therefore, be taken to prevent unnecessary delay of surgery in elderly patients requiring hip hemiarthroplasty.</p>

A prospective study of risk factors for first trimester miscarriage in Asian women with threatened miscarriage

<p><b>INTRODUCTION</b>The present study aimed to assess the demographic, socioeconomic, medical and lifestyle factors associated with the progression of a threatened miscarriage to a complete miscarriage in the first trimester.</p><p><b>METHODS</b>A prospective cohort study was conducted on 157 women who presented with vaginal bleeding in the fifth to tenth week of gestation. Cox regression analysis was used to determine the risk factors for progression to a complete miscarriage within 16 weeks of gestation.</p><p><b>RESULTS</b>Of the 139 women included for data analysis, 36 (25.9%) had a miscarriage, mostly within two weeks of presentation. The results of our study showed that women aged ≥ 34 years were more likely to miscarry (hazard ratio [HR] = 1.95). Compared to women whose partner was 20-30 years of age, women whose partner was ≥ 41 years of age also had a higher likelihood of experiencing a miscarriage (HR = 8.33). However, the presence of nausea (HR = 0.33) and a high stress score (i.e. ≥ 17) on the Perceived Stress Scale (HR = 0.49) were associated with a reduced likelihood of miscarriage.</p><p><b>CONCLUSION</b>Older pregnant women experiencing a threatened miscarriage should be counselled about their higher risk of miscarriage, especially if they have an older partner.</p>