Seasonal effect on the incidence of post-operative wound complications after trauma-related surgery of the foot, ankle and lower leg

Sanders, Fay R K; Hul, Mirjam Van't; Kistemaker, Rosanne Maria Güzelleke; Schepers, Tim

doi:10.1007/s00402-020-03395-6

Cited by 5 publications

(4 citation statements)

References 33 publications

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“…Spinal surgery, total joint replacement, as well as foot and ankle surgery carried out in summer were associated with a higher risk of surgical site complications compared with winter. [24][25][26][27] However, the association between season and systemic complications or mortality remains unknown in hip fracture surgery. Observational studies in Europe and Asia showed a higher incidence of hip fracture in winter.…”

Section: Discussionmentioning

confidence: 99%

Seasonality of mortality and in‐hospital complications in hip fracture surgery: Retrospective cohort research using a nationwide inpatient database

Ogawa

Yoshii

Higuchi

et al. 2021

Geriatrics Gerontology Int

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Among older patients undergoing hip fracture surgery, previous studies have shown a seasonal variation of in-hospital surgical complications. However, little is known about seasonal effects on mortality and systemic complications after hip fracture surgery. In the present study, we evaluated whether mortality and in-hospital systemic complications are influenced by seasonal differences.Methods: We enrolled patients from a nationwide database who underwent hip fracture surgery between 2010 and 2018. The primary outcome was in-hospital mortality. The secondary outcomes were in-hospital systemic complications. The association between the seasonality and in-hospital outcomes was investigated using multivariable Cox, logistic regression and causal mediation analysis.Results: With 425 856 patients (mean age 83.5 years; 79% women), overall in-hospital mortality was 5324 (1.2%). Fall and winter were associated with a higher mortality than spring (hazard ratio [HR] 1.16; P < 0.001; HR 1.14; P = 0.001, respectively). Across all the seasons, there were 36 834 overall systemic complications (8.6%), with respiratory infection being the most frequent (18 637 [4.4%]). Among these complications, only respiratory infection showed seasonal variation, with a higher prevalence in fall and winter. The mediated effect of respiratory infection on mortality was significantly higher in fall and winter compared with spring (fall, HR 1.06, proportion mediated 36.7%; winter, HR 1.14, proportion mediated 55.0%; all P < 0.001). Conclusions:We found a significantly higher mortality in fall and winter after hip fracture surgery. Specifically, in winter, the increased in-hospital death was largely attributed to the increased incidence of respiratory infection.

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Section: Discussionmentioning

confidence: 99%

Seasonality of mortality and in‐hospital complications in hip fracture surgery: Retrospective cohort research using a nationwide inpatient database

Ogawa

Yoshii

Higuchi

et al. 2021

Geriatrics Gerontology Int

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“… 11 No effect of season has been noted on post-operative wound complications after trauma to the foot, ankle or lower leg. 12 Another study found no difference in seasonal variation of complications 30 days after THA. 13 Taken as a whole, the body TJA literature remains inconclusive on the role of season of index surgery on outcomes.…”

Section: Introductionmentioning

confidence: 97%

The Association of Season of Surgery and Patient Reported Outcomes following Total Hip Arthroplasty

Lachance,

Call,

Radford

et al. 2024

Geriatr Orthop Surg Rehabil

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Background Understanding the impact of situational variables on surgical recovery can improve outcomes in total hip arthroplasty (THA). Literature examining hospital outcomes by season remains inconclusive, with limited focus on patient experience. The aim of this study is to investigate if there are differences in hospital and patient-reported outcomes measures (PROMS) after THA depending on the season of the index procedure to improve surgeon preoperative counseling. Methods A retrospective chart review was performed on patients undergoing primary THA at a single large academic center between January 2013 and August 2020. Demographic, operative, hospital, and PROMs were gathered from the institutional electronic medical record and our institutional joint replacement outcomes database. Results 6418 patients underwent primary THA and met inclusion criteria. Of this patient population, 1636 underwent surgery in winter, 1543 in spring, 1811 in summer, and 1428 in fall. PROMs were equivalent across seasons at nearly time points. The average age of patients was 65 (+/- 10) years, with an average BMI of 29.3 (+/- 6). Rates of complications including ED visits within 30 days, readmission within 90 days, unplanned readmission, dislocation, fracture, or wound infection were not significantly different by season ( P > .05). Conclusion Our findings indicate no differences in complications and PROMs at 1 year in patients undergoing THA during 4 distinct seasons. Notably, patients had functional differences at the second follow-up visit, suggesting variation in short-term recovery. Patients could be counseled that they have similar rates of complications and postoperative recovery regardless of season.

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“…Therefore, we conducted a review similar to the review of Backes et al, 4) where we collected data regarding POWCs and infections for surgery via STA whilst combining it with geographical differences including differences in climate. 13 14) Additionally, the correlations between the mean temperature of a country, frequency of performed surgeries, and functional outcome scores were analyzed in order to explain possible differences found between individual countries. 13 14) …”

mentioning

confidence: 99%

“… 13 14) Additionally, the correlations between the mean temperature of a country, frequency of performed surgeries, and functional outcome scores were analyzed in order to explain possible differences found between individual countries. 13 14) …”

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confidence: 99%

Geographical Differences in Wound Complication Rates Following the Sinus Tarsi Approach in Displaced Intra-articular Calcaneal Fractures: A Systematic Review of the Literature

Eelsing,

Ahmadi,

Halm

et al. 2024

Clin Orthop Surg

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Background The sinus tarsi approach (STA) has gained popularity for the treatment of displaced intra-articular calcaneal fractures. No large studies comparing wound complications worldwide after STA surgery are available. The aim of this systematic review was to compare postoperative wound complication (POWC) and postoperative wound infection (POWI) rates following STA surgery between continents and countries and their differences in climate. Methods A literature search was performed using the databases of PubMed, Embase, and the Cochrane Library. Studies published before January 1, 2000, including < 10 patients and written in a language other than English were excluded. Results In total, 86 studies containing 4,392 surgeries via STA from 20 different countries were included. The mean POWC was 5.9% and the mean POWI was 4.4%. The highest median POWC rate was in North America (8.5%) and the lowest in South America (2.0%). No significant differences were found in the POWC and POWI rates between countries ( p = 0.178 and p = 0.570, respectively), but significant differences were found between the POWC and POWI rates between continents ( p = 0.011 and p = 0.036, respectively). The number of surgeries per year and climate differences, as represented by mean local temperature, were not correlated with both the POWC/POWI rates and functional outcome scores. Conclusions Significant differences between the POWC and POWI rates were found between continents but not between individual countries. With a mean POWC of 5.9% and a mean POWI rate of 4.4%, STA has an intrinsic low risk for complications given the minimally invasive nature of the approach and is inevitably becoming the gold standard for calcaneal surgery.

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Seasonal effect on the incidence of post-operative wound complications after trauma-related surgery of the foot, ankle and lower leg

Cited by 5 publications

References 33 publications

Seasonality of mortality and in‐hospital complications in hip fracture surgery: Retrospective cohort research using a nationwide inpatient database

Seasonality of mortality and in‐hospital complications in hip fracture surgery: Retrospective cohort research using a nationwide inpatient database

The Association of Season of Surgery and Patient Reported Outcomes following Total Hip Arthroplasty

Geographical Differences in Wound Complication Rates Following the Sinus Tarsi Approach in Displaced Intra-articular Calcaneal Fractures: A Systematic Review of the Literature

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