Prevalence and determinants of orthopedic surgical site infections in rural northern Ghana: a retrospective cohort study

Abstract

BackgroundThe annual incidence of orthopedic surgeries has been steadily rising globally. The rise in orthopedic surgeries is associated with increased surgical site infection, which is linked with high mortality, extended hospital stays, and decreased quality of patient life. There is a dearth of knowledge on the magnitude and risk factors of orthopedic surgical site infections in Ghana.ObjectiveTo investigate the prevalence and determinants of orthopedic surgical site infections in St. Theresa’s Hospital, Nandom.MethodA retrospective cohort design among 1032 patients who underwent orthopedic surgeries between January 2014 and December 2018. Admission and patient record books constituted the data sources. The data were initially extracted into a Microsoft Excel spreadsheet, cleaned, and exported to SPSS version 27 and R for coding and analysis.ResultsThe prevalence of orthopedic surgical site infection was 9.3%. The determinants of orthopedic surgical site infections were: male sex (OR = 2.33, 95%CI 1.04, 5.51) p = 0.04; self-employed (OR = 3.25, 95%CI 1.2, 10.29) p = 0.030; unemployed/retired (OR = 4.61, 95%CI 1.35, 17.72) p = 0.019; duration of admission (OR = 1.03, 95%CI 1.01, 1.05) p = 0.002; number of days on postoperative medications (OR = 1.21, 95%CI 1, 1.46) p = 0.045; white blood cell count (OR = 1.04, 95%CI 0.98, 1.08) p = 0.050; and revised surgery (OR = 9.89, 95%CI 5.32, 18.79) p = 0.001.ConclusionThis study's prevalence of orthopedic surgical site infection was 9.3%. Surgical site infections are the most surveyed and common types of healthcare-associated infections that occur in low and middle-income countries. Several factors may contribute to these infections. Standardized guidelines are needed to consolidate the prevention of these infections globally.