Postoperative Surgical Site Infections in Neck of Femur Fracture Surgeries: A Retrospective Study on Incidence, Risk Factors, and Outcomes at Lautoka Hospital

Background: Neck of femur (NOF) fractures are a major public health issue for Fiji’s aging population, with surgical site infections (SSIs) being a devastating complication that increases morbidity, mortality, and healthcare costs. This study provides the first detailed analysis of SSI incidence and its associated risk factors in NOF fracture surgeries at Lautoka Hospital. Methodology: A retrospective, cross-sectional study was conducted on 56 patients who underwent NOF fracture surgery at Lautoka Hospital. Data on patient demographics, clinical factors, and postoperative outcomes were collected from hospital electronic medical records (EMR), registers, and clinical staff interviews. The study received full ethical approval from the Fiji Human Health Research Ethics Review Committee (FNHRERC) and Aspen Medical. Results: The study identified an alarming SSI rate of 8.9%. The patient cohort was characteristically geriatric, with a mean age of 69.1 years. Significant risk factors included a high burden of comorbidities (nearly 80% of patients had at least one chronic illness), with diabetes and hypertension being prevalent. Systemic delays were a critical issue, with 71.4% of patients waiting over 48 hours for surgery. The median length of hospital stay was 6 days, but outliers extended up to 56 days, often linked to infection. Staphylococcus aureus was a primary causative organism identified. Conclusion: The high SSI rate is driven by a combination of a vulnerable, comorbid patient population and significant, modifiable systemic delays in care. The findings underscore an urgent need for targeted, low-cost interventions focused on streamlining preoperative pathways, ensuring protocol adherence, and enhancing postoperative care to improve patient outcomes in Fiji.