Pyuria in hip fracture and coxarthrosis : Kalça kırığı ve koksartrozda piyüri

Ahmet  Aslan; Remzi Arif Özerdemoğlu; Fazıl Cüneyt Aydoğan; Hüseyin Yorgancıgil; Özgür Karakoyun

doi:10.5455/GMJ-30-2012-78

Authors

Ahmet Aslan Afyonkarahisar Devlet Hastanesi, Ortopedi ve Travmatoloji Kliniği, Afyonkarahisar
Remzi Arif Özerdemoğlu Özel Sema Hastanesi, Ortopedi ve Travmatoloji Kliniği, İstanbul
Fazıl Cüneyt Aydoğan Dr .İ. Şevki Atasagun Nevşehir Devlet Hastanesi, Ortopedi ve Travmatoloji Kliniği, Nevşehir
Hüseyin Yorgancıgil Süleyman Demirel Üniversitesi, Tıp Fakültesi, Ortopedi ve Travmatoloji Anabilim Dalı, Isparta
Özgür Karakoyun Dr.Münif İslamoğlu Kastamonu Devlet Hastanesi, Ortopedi ve Travmatoloji Kliniği, Kastamonu

DOI:

https://doi.org/10.5455/GMJ-30-2012-78

Keywords:

Surgical wound infection, urinary tract infections, hip fracture, coxarthrosis, pyuria

Abstract

Accompanying systemic pathologies and other risk factors can be found in the most elderly patients who treated for hip fracture or coxarthrosis. All of these can cause urinary tract infection and colonization of bacteria in the urinary tract. Pyuria and urinary tract infection could pose a risk after the orthopedic implant surgery and is a frightening complication of surgical site wound infection. In this study, we investigated that the relationship between preoperative pyuria and postoperative surgical site infections, affect the risk factors in patients who underwent hip implant surgery or hip arthroplasty because of hip fracture or coxarthrosis. The period between 1994-2008, 563 patients with at least one year follow-up records were reviewed retrospectively. Working group was comprised of 38 cases detected preoperative pyuria (urine microscopy >10 white blood cell/field), the 62 patients that were randomly selected among the rest of 525 patients constituted the control group. Groups of age, gender, etiology, fever, hemoglobin, sedimentation rate, Creactive protein, white blood cell, albumin, preoperative period of time, diabetes, co-morbidities, urine culture in terms of reproductive and post-operative surgical site infection were compared. In the study group, blood albumin level was lower than the control group. In addition, the preoperative period and postoperative surgical site infection, urine culture positivity were higher than the control group. There was statistical difference between groups (p<0.05). We found no statistical difference between groups in terms of other parameters (age, gender, etiology, fever, hemoglobin, sedimentation rate, C-reactive protein, white blood cell, diabetes, comorbidities) (p>0.05). The results of this study, preoperative length of time, culture positivity and low level of albumin show significant risk factors for postoperative surgical site infection. In addition to the preoperative symptomatic urinary tract infection seems associated with surgical wound infection after surgery. Orthopedic surgery can be delayed until the preoperative treatment of symptomatic urinary tract infection, however we think that there is no correlation between preoperative asymptomatic pyuria and postoperative surgical site infection. And it is not necessary to delay orthopedic surgery in patients with asymptomatic pyuria.

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