Hand infection patients presenting to an orthopaedic unit: An audit of incidence and demographics at a rural hospital.

ObjectiveHand infections are a common presentation to health services in the Northern Territory; however, little is known about these patients. This study aims to identify incidence, treatment and co-morbidities of hand infection patients and to pinpoint factors associated with poor outcome. DesignA retrospective study of all patients presenting to Alice Springs Hospital with a hand infection during 2012. SettingOrthopaedic Unit at Alice Springs Hospital. ParticipantsAll patients admitted with a hand infection were included. Main outcome measuresAdmission duration, duration waited before first presentation, re-admission rate, duration of re-admission and rate of methicillin-resistant Staphylococcus aureus. ResultsOne hundred fourteen cases of hand infections were admitted to Alice Springs Hospital during 2012, of which 87 (76%) were in Indigenous patients. Indigenous patients (P=0.001) and older patients (P=0.038) had significantly longer admissions. Indigenous patients were 9.52 times (P=0.038) more likely to be re-admitted than non-Indigenous patients. The rate of methicillin-resistant Staphylococcus aureus was 24.6%, and this was associated with smoking (P=0.049) and substance abuse (P=0.036). Formal follow-up was not related to indirect measures of hand infection severity, such as admission duration or re-admissions. ConclusionHand infections are a common presentation to Alice Springs Hospital. Indigenous people are admitted 2.38 times longer after adjusting for age and alcohol abuse. They have a more than ninefold chance of being re-admitted to hospital than non-Indigenous people following a hand infection.