Summary
Background
Previous studies reported higher incidence of surgical site infection (SSI) after
procedures performed in summer or with high temperatures. However, no study used detailed
climate data to assess this risk after hip and knee arthroplasty, and no study specifically
investigated the role of heatwaves.
Aim
To assess the impact of higher environmental temperatures and heatwaves on SSI rates
after hip and knee arthroplasty.
Methods
Data on hip and knee arthroplasty procedures performed between January 2013 and September
2019 in hospitals participating in the Swiss SSI surveillance were linked to climate
data extracted from weather stations located in their vicinity. The association between
temperature, heatwaves and SSI was studied using mixed effects logistic regression
models fitted at the patient level. Poisson mixed models were fitted for both calendar
year and month of the year to investigate the SSI incidence trajectory over time.
Results
We included 116,981 procedures performed in 122 hospitals. Significantly higher SSI
rates were observed for procedures performed in the summertime (incidence rate ratio
1.39, 95% CI (1.20–1.60), P<0.001; reference: autumn) or in calendar months in which the mean temperature was
above 20 °C (reference 5–10 °C; odds ratio 1.59, 95% CI (1.27, 1.98), P<0.001). We observed a slight but non-significant increase in the rate of SSI during
heatwaves (1.44% versus 1.01%, P=0.2).
Conclusion
SSI rates after hip and knee replacement appear to increase with higher environmental
temperature. To establish whether, and to what extent, heatwaves increase the risk
of SSI, studies involving geographical areas with larger variability in temperature
are needed.
Keywords
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Article info
Publication history
Published online: March 28, 2023
Accepted:
March 18,
2023
Received:
January 23,
2023
Identification
Copyright
© 2023 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.
