Surgical Site Infections Following Pediatric Ambulatory Surgery: An Epidemiologic Analysis

2016 ◽  
Vol 37 (8) ◽  
pp. 931-938 ◽  
Author(s):  
Michael L. Rinke ◽  
Dominique Jan ◽  
Janelle Nassim ◽  
Jaeun Choi ◽  
Steven J. Choi
Keyword(s):  
Risk Factors ◽  
Sensitivity And Specificity ◽  
Random Sampling ◽  
Ambulatory Surgery ◽  
Care Center ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Systematic Random Sampling ◽  
National Healthcare ◽  
National Healthcare Safety Network

OBJECTIVETo identify surgical site infection (SSI) rates following pediatric ambulatory surgery, SSI outcomes and risk factors, and sensitivity and specificity of SSI administrative billing codes.DESIGNRetrospective chart review of pediatric ambulatory surgeries with International Classification of Disease, Ninth Revision (ICD-9) codes for SSI, and a systematic random sampling of 5% of surgeries without SSI ICD-9 codes, all adjudicated for SSI on the basis of an ambulatory-adapted National Healthcare Safety Network definition.SETTINGUrban pediatric tertiary care center April 1, 2009-March 31, 2014.METHODSSSI rates and sensitivity and specificity of ICD-9 codes were estimated using sampling design, and risk factors were analyzed in case–rest of cohort, and case-control, designs.RESULTSIn 15,448 pediatric ambulatory surgeries, 34 patients had ICD-9 codes for SSI and 25 met the adapted National Healthcare Safety Network criteria. One additional SSI was identified with systematic random sampling. The SSI rate following pediatric ambulatory surgery was 2.9 per 1,000 surgeries (95% CI, 1.2–6.9). Otolaryngology surgeries demonstrated significantly lower SSI rates compared with endocrine (P=.001), integumentary (P=.001), male genital (P<.0001), and respiratory (P=.01) surgeries. Almost half of patients with an SSI were admitted, 88% received antibiotics, and 15% returned to the operating room. No risk factors were associated with SSI. The sensitivity of ICD-9 codes for SSI following ambulatory surgery was 55.31% (95% CI, 12.69%–91.33%) and specificity was 99.94% (99.89%–99.97%).CONCLUSIONSSSI following pediatric ambulatory surgery occurs at an appreciable rate and conveys morbidity on children.Infect Control Hosp Epidemiol 2016;37:931–938

Surgical site infections following spinal surgery at a tertiary care center in Lebanon: Incidence, microbiology, and risk factors

2006 ◽  
Vol 38 (8) ◽  
pp. 589-592 ◽  
Author(s):  
Zeina A. Kanafani ◽  
Ghenwa K. Dakdouki ◽  
Oussayma El-Dbouni ◽  
Tala Bawwab ◽  
Souha S. Kanj
Keyword(s):  
Risk Factors ◽  
Spinal Surgery ◽  
Care Center ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Tertiary Care Center

scholarly journals Comparing External Ventricular Drains-Related Ventriculitis Surveillance Definitions

2017 ◽  
Vol 38 (5) ◽  
pp. 574-579 ◽  
Author(s):  
Maria M. Reyes ◽  
Satish Munigala ◽  
Emily L. Church ◽  
Tobias B. Kulik ◽  
Salah G. Keyrouz ◽  
...  
Keyword(s):  
Retrospective Cohort ◽  
Care Center ◽  
External Ventricular Drain ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Test Results ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Large Tertiary Care ◽  
Culture Positive

OBJECTIVETo evaluate the agreement between the current National Healthcare Safety Network (NHSN) definition for ventriculitis and others found in the literature among patients with an external ventricular drain (EVD)DESIGNRetrospective cohort study from January 2009 to December 2014SETTINGNeurology and neurosurgery intensive care unit of a large tertiary-care centerPATIENTSPatients with an EVD were included. Patients with an infection prior to EVD placement or a permanent ventricular shunt were excluded.METHODSWe reviewed the charts of patients with positive cerebrospinal fluid (CSF) cultures and/or abnormal CSF results while they had an EVD in place and applied various ventriculitis definitions.RESULTSWe identified 48 patients with a total of 52 cases of ventriculitis (41 CSF culture-positive cases and 11 cases based on abnormal CSF test results) using the NHSN definition. The most common organisms causing ventriculitis were gram-positive commensals (79.2%); however, 45% showed growth of only 1 colony on 1 piece of media. Approximately 60% of the ventriculitis cases by the NHSN definition met the Honda criteria, approximately 56% met the Gozal criteria, and 23% met Citerio’s definition. Cases defined using Honda versus Gozal definitions had a moderate agreement (κ=0.528; P<.05) whereas comparisons of Honda versus Citerio definitions (κ=0.338; P<.05) and Citerio versus Gozal definitions (κ=0.384; P<.05) had only fair agreements.CONCLUSIONSThe agreement between published ventriculostomy-associated infection (VAI) definitions in this cohort was moderate to fair. A VAI surveillance definition that better defines contaminants is needed for more homogenous application of surveillance definitions between institutions and better comparison of rates.Infect Control Hosp Epidemiol 2017;38:574–579

Study of risk factors of eclampsia in a tertiary care center

2019 ◽  
Vol 12 (2) ◽  
pp. 31-35
Author(s):  
Padma Chandavathu ◽  
◽  
Akurathi Krishna Rao ◽  
Keyword(s):  
Risk Factors ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center

scholarly journals Prevalence and risk factors of anemia among pregnant women attending a high-volume tertiary care center for delivery

2015 ◽  
Vol 16 (4) ◽  
pp. 231-236 ◽  
Author(s):  
Cuneyt Eftal Taner ◽  
Atalay Ekin ◽  
Ulas Solmaz ◽  
Cenk Gezer ◽  
Birgul Cetin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Care Center ◽  
Tertiary Care ◽  
High Volume ◽  
Tertiary Care Center

scholarly journals 881. Efficacy of Antibiotic Prophylaxis with Vancomycin in Cardiothoracic Surgery

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S477-S477
Author(s):  
Margaret Cooper ◽  
Jing Zhao
Keyword(s):  
Primary Outcome ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Medical Center ◽  
Surgical Site Infections ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
High Incidence ◽  
The Difference ◽  
Gram Negative Organisms ◽  
Discernible Difference

Abstract Background Due to the high incidence of methicillin-resistant Staphylococcus aureus (MRSA) at the Detroit Medical Center, vancomycin is now routinely part of the prophylaxis regimen for cardiothoracic (CT) surgery. The study aims to compare the rate and types of surgical site infections (SSIs) when vancomycin is added to cefazolin for CT surgery compared to cefazolin alone. Methods This was a retrospective cohort study conducted at two university-affiliated hospitals. Patients who underwent CT surgery between January 2008 and August 2017 and had a readmission for SSI within 90 days of procedure were included. Patients who received cefazolin were compared to patients who received both cefazolin and vancomycin for CT surgery prophylaxis. The primary outcome was incidence of SSIs within 90 days of surgery as defined by the Centers for Disease Control and National Healthcare Safety Network. Results Out of 828 patients who underwent CT surgeries, there were 32 patients readmitted within 90 days for SSI. SSI occurred in 4.7% of patients who received cefazolin monotherapy, and 2.4% of patients who received both cefazolin and vancomycin (p=0.095). There was no discernible difference in types of SSI between groups. Pathogens were isolated in 78% of SSIs, with 75% Gram-positive and 19% Gram-negative organisms. SSIs resulted in an average 9.8 days in the hospital and 28.9 days of antibiotic therapy, and led to a total of 15 additional procedures. Conclusion Vancomycin added to cefazolin for prophylaxis in CT surgery resulted in lower incidence of SSI, however the difference was not statistically significant. Disclosures All Authors: No reported disclosures

scholarly journals Risk factors associated with birth defects at a tertiary care center in Pakistan

2012 ◽  
Vol 38 (1) ◽  
pp. 68 ◽  
Author(s):  
Mohammad Zeeshan Raza ◽  
Asfandyar Sheikh ◽  
Syed Salman Ahmed ◽  
Sajid Ali ◽  
Syed Mumtaz Ali Naqvi
Keyword(s):  
Risk Factors ◽  
Birth Defects ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Factors Associated

GASTRIC CANCER: A 5 YEAR RETROSPECTIVE ANALYSIS OF CLINICAL, PATHOLOGICAL AND TREATMENT ASPECTS FROM A TERTIARY CARE CENTER IN SOUTH INDIA.

2021 ◽  
pp. 129-132
Author(s):  
B. Ramkumar ◽  
J. Kannan ◽  
Ingersal. N ◽  
Srigopal mohanty ◽  
Amit saklani ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
South India ◽  
Care Center ◽  
Tertiary Care ◽  
Tumor Location ◽  
Advanced Stage ◽  
Tertiary Care Center ◽  
Nodal Disease ◽  
Female Ratio

Context: Gastric cancer(GC) is fth most common cancer worldwide. Mostly presents with advanced stage and poor overall survival. Methods: Retrospective study on clinical, pathological, pattern of distant metastasis(DM) , treatment aspect of GC treated between January 2014 to December 2018 in a tertiary care center in south India. Statistical analysis : Chi square test and multivariate analysis (MVA) were used for analysis. P <0.05 was considered signicant. Results: Median age at diagnosis is 57 years. Higher male : female ratio. Most common presentation was abdominal pain followed vomiting. Malignant Gastric outlet obstruction(MGOO) was present in 22.7%. Histologically , all patients had adenocarcinoma with predominantly moderate differentiation (51.1%). Liver (19.1%)was most common site of metastasis . Curative surgery was done in 35.5% of patients. D2 lymph node dissection was performed in 12.4% of patient. Patients were given perioperative /preoperative/ adjuvant / palliative chemotherapy. MVA revealed history of tobacco use, body of stomach tumor location, nodal disease were risk factors for DM. Conclusion : The present analysis revealed use of tobacco, alcohol intake were main risk factors for GC. Most of the patients present in advanced stage , so prevention by avoiding risk factors and early detection by signs , symptoms and endoscopy are necessary. Use of tobacco,site of tumor location, nodal disease were factors associated with DM. Aggressive management with both surgery and chemotherapy is warranted for locally advanced disease.

Usefulness of some current balance tests for identifying individuals with disequilibrium due to vestibular impairments

2009 ◽  
Vol 18 (5-6) ◽  
pp. 295-303
Author(s):  
Helen S. Cohen ◽  
Kay T. Kimball
Keyword(s):  
Sensitivity And Specificity ◽  
Care Center ◽  
Tertiary Care ◽  
High Sensitivity ◽  
Community Dwelling ◽  
Functional Mobility ◽  
Vestibular Disorders ◽  
Timed Up And Go ◽  
Balance Tests ◽  
Walking Balance

The goal of this study was to determine which of several clinical balance tests best identifies patients with vestibular disorders. We compared the scores of normals and patients on the Berg Balance Scale (Berg), Dynamic Gait Index (DGI), Timed Up and Go (TUG), Computerized Dynamic Posturography Sensory Organization Test (SOT), and a new obstacle avoidance test: the Functional Mobility Test (FMT). The study was performed in an out-patient balance laboratory at a tertiary care center. Subjects were 40 normal adults, and 40 adults with vestibular impairments. The main outcome measures were the sensitivity of tests to patients and specificity to normals. When adjusted for age the Berg, TUG, DGI and FMT had moderate sensitivity and specificity. SOT had moderately high sensitivity and specificity. SOT and FMT, combined, had high sensitivity and moderate specificity. Therefore, the kinds of tests of standing and walking balance that clinicians may use to screen patients for falling are not as good for screening for vestibular disorders as SOT. SOT combined with FMT is better. When screening patients for vestibular disorders, when objective diagnostic tests of the vestibular system, itself, are unavailable, tests of both standing and walking balance, together, give the most information about community-dwelling patients. These tests may also indicate the presence of sub-clinical balance problems in community-dwelling, asymptomatic adults.

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