Rates of Surgical Site Infection After Hip Replacement as a Hospital Performance Indicator: Analysis of Data From the English Mandatory Surveillance System

2008 ◽  
Vol 29 (3) ◽  
pp. 219-226 ◽  
Author(s):  
J. Wilson ◽  
A. Charlett ◽  
G. Leong ◽  
C. McDougall ◽  
G. Duckworth
Keyword(s):  
Confidence Interval ◽  
Surgical Site Infection ◽  
Hip Replacement ◽  
Performance Indicator ◽  
Hospital Performance ◽  
Incidence Rates ◽  
Site Infection ◽  
Risk Of Infection ◽  
Data Set ◽  
Funnel Plots

Objective.To describe rates of surgical site infection (SSI) after hip replacement and to use these data to provide a simple mechanism for identifying poorly performing hospitals that takes into account variations in sample size.Design.Prospective surveillance study.Setting.A total of 125 acute care hospitals in England that participated in mandatory SSI surveillance from April 1, 2004 through March 31, 2005.Patients.Patients who underwent total hip replacement (THR) or hip hemiarthroplasty (HH).Methods.A standard data set was collected for all eligible operations at participating hospitals for a minimum of 3 months annually. Defined methods were used to identify SSIs that occurred during the inpatient stay. Data were checked for quality and accuracy, and funnel plots were constructed by plotting the incidence of SSI against the number of operations.Results.Data were collected on 16,765 THRs and 5,395 HHs. The cumulative SSI incidence rates were 1.26% for THR and 4.06% for HH; the incidence densities were 1.38 SSIs per 1,000 postoperative inpatient days for THR and 2.3 SSIs per 1,000 postoperative inpatient days for HH. The risk of infection associated with revision surgery was significantly higher than that associated with primary surgery (2.7% [95% confidence interval, 2.0%-3.5%] vs. 1.1% [95% confidence interval, 1.0%-1.2%];P = .003). Rates varied considerably among hospitals. Nineteen hospitals had rates above the 90th percentile. However, the use of funnel plots to adjust for the precision of estimated SSI rates identified 7 hospitals that warranted further investigation, including 2 with crude rates below the 90th percentile.Conclusions.Funnel plots of rates of SSI after hip replacement provide a valuable method of presenting hospital performance data, clearly identifying hospitals with unusually high or low rates while adjusting for the precision of the estimated rate. This information can be used to target and support local interventions to reduce the risk of infection.

scholarly journals O052: Use of surgical-site infection rates to rank hospital performance across several types of surgery

2013 ◽  
Vol 2 (S1) ◽  
Author(s):  
AM van Dishoeck ◽  
MB Koek ◽  
EW Steyerberg ◽  
BH van Benthem ◽  
MC Vos ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Hospital Performance ◽  
Site Infection ◽  
Infection Rates

scholarly journals Cost–benefit analysis of surveillance for surgical site infection following caesarean section

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e036919 ◽  
Author(s):  
Catherine Wloch ◽  
Albert Jan Van Hoek ◽  
Nathan Green ◽  
Joanna Conneely ◽  
Pauline Harrington ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Health Service ◽  
Surgical Site Infection ◽  
Effective Means ◽  
Surgical Site Infections ◽  
Infection Risk ◽  
Baseline Risk ◽  
Site Infection ◽  
Risk Of Infection ◽  
Surveillance Strategy

ObjectiveTo estimate the economic burden to the health service of surgical site infection following caesarean section and to identify potential savings achievable through implementation of a surveillance programme.DesignEconomic model to evaluate the costs and benefits of surveillance from community and hospital healthcare providers’ perspective.SettingEngland.ParticipantsWomen undergoing caesarean section in National Health Service hospitals.Main outcome measureCosts attributable to treatment and management of surgical site infection following caesarean section.ResultsThe costs (2010) for a hospital carrying out 800 caesarean sections a year based on infection risk of 9.6% were estimated at £18 914 (95% CI 11 521 to 29 499) with 28% accounted for by community care (£5370). With inflation to 2019 prices, this equates to an estimated cost of £5.0 m for all caesarean sections performed annually in England 2018–2019, approximately £1866 and £93 per infection managed in hospital and community, respectively. The cost of surveillance for a hospital for one calendar quarter was estimated as £3747 (2010 costs). Modelling a decrease in risk of infection of 30%, 20% or 10% between successive surveillance periods indicated that a variable intermittent surveillance strategy achieved higher or similar net savings than continuous surveillance. Breakeven was reached sooner with the variable surveillance strategy than continuous surveillance when the baseline risk of infection was 10% or 15% and smaller loses with a baseline risk of 5%.ConclusionSurveillance of surgical site infections after caesarean section with feedback of data to surgical teams offers a potentially effective means to reduce infection risk, improve patient experience and save money for the health service.

The Relationship of Hospital Charges and Volume to Surgical Site Infection After Total Hip Replacement

2014 ◽  
Vol 30 (3) ◽  
pp. 283-288 ◽  
Author(s):  
Rebecca Boas ◽  
Kelsey Ensor ◽  
Edward Qian ◽  
Lorraine Hutzler ◽  
James Slover ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Hospital Charges ◽  
Site Infection ◽  
Total Hip ◽  
Relationship Of ◽  
The Relationship

scholarly journals Smoking increases the risk of surgical site infection after hydrocelectomy in adults: a retrospective cohort study in Brazil

2018 ◽  
Vol 11 (12) ◽  
pp. 950-956
Author(s):  
Thiago Silva Da Costa ◽  
Paulo José De Medeiros ◽  
Mauro José Costa Salles
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Confidence Interval ◽  
Surgical Site Infection ◽  
Retrospective Cohort Study ◽  
Odds Ratio ◽  
Retrospective Cohort ◽  
Univariate Analysis ◽  
Smoking Habits ◽  
Site Infection

Introduction: Surgical site infection (SSI) following hydrocelectomy is relatively uncommon, but it is one of the main post-operative problems. We aimed to describe the prevalence of SSI following hydrocelectomy among adult patients, and to assess predisposing risk factors for infection. Methodology: This retrospective cohort study was carried out at a university hospital and included hydrocelectomies performed between January 2007 and December 2014. Diagnosis of SSI was performed according to the Center for Diseases Control (CDC) guidelines. Multivariable logistic regression analysis was used to identify independent risk factors. Results: A total of 196 patients were included in the analysis. Overall, 30 patients were diagnosed with SSI (15.3%) and of these, 63.3% (19/30) were classified as having superficial SSI, while 36.7% (11/30) had deep SSI. The main signs and symptoms of infection were the presence of surgical wound secretion (70%) and inflammatory superficial signs such as hyperemia, edema and pain (60%). Among the 53 patients presenting chronic smoking habits, 26.4% (14⁄53) developed SSI, which was associated with a higher risk for SSI (odds ratio [OR] = 2.84, 95% confidence interval [CI] = 1.27 to 6.35, p < 0.01) in the univariate analysis. In the adjusted multivariable analysis, smoking habits were also statistically associated with SSI after hydrocelectomy (odds ratio [OR] = 2.84, 95% confidence interval [CI] = 1.30 to 6.24, p = 0.01). No pre-, intra-, or post-operative variable analyzed showed an independent association to SSI following hydrocelectomy. Conclusions: Smoking was the only independent modifiable risk factor for SSI in the multivariate analysis.

The role of postoperative antibiotic duration on surgical site infection after lumbar surgery

2021 ◽  
pp. 1-7
Author(s):  
Mohamed Macki ◽  
Travis Hamilton ◽  
Seokchun Lim ◽  
Tarek R. Mansour ◽  
Edvin Telemi ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Spine Surgery ◽  
Multivariable Analysis ◽  
Antibiotic Use ◽  
Site Infection ◽  
Data Set ◽  
Comorbidity Burden ◽  
Comparison Groups ◽  
Term Administration ◽  
Antibiotic Duration

OBJECTIVE Despite a general consensus regarding the administration of preoperative antibiotics, poorly defined comparison groups and underpowered studies prevent clear guidelines for postoperative antibiotics. Utilizing a data set tailored specifically to spine surgery outcomes, in this clinical study the authors aimed to determine whether there is a role for postoperative antibiotics in the prevention of surgical site infection (SSI). METHODS The Michigan Spine Surgery Improvement Collaborative registry was queried for all lumbar operations performed for degenerative spinal pathologies over a 5-year period from 2014 to 2019. Preoperative prophylactic antibiotics were administered for all surgical procedures. The study population was divided into three cohorts: no postoperative antibiotics, postoperative antibiotics ≤ 24 hours, and postoperative antibiotics > 24 hours. This categorization was intended to determine 1) whether postoperative antibiotics are helpful and 2) the appropriate duration of postoperative antibiotics. First, multivariable analysis with generalized estimating equations (GEEs) was used to determine the association between antibiotic duration and all-type SSI with adjusted odds ratios; second, a three-tiered outcome—no SSI, superficial SSI, and deep SSI—was calculated with multivariable multinomial logistical GEE analysis. RESULTS Among 37,161 patients, the postoperative antibiotics > 24 hours cohort had more men with older average age, greater body mass index, and greater comorbidity burden. The postoperative antibiotics > 24 hours cohort had a 3% rate of SSI, which was significantly higher than the 2% rate of SSI of the other two cohorts (p = 0.004). On multivariable GEE analysis, neither postoperative antibiotics > 24 hours nor postoperative antibiotics ≤ 24 hours, as compared with no postoperative antibiotics, was associated with a lower rate of all-type postoperative SSIs. On multivariable multinomial logistical GEE analysis, neither postoperative antibiotics ≤ 24 hours nor postoperative antibiotics > 24 hours was associated with rate of superficial SSI, as compared with no antibiotic use at all. The odds of deep SSI decreased by 45% with postoperative antibiotics ≤ 24 hours (p = 0.002) and by 40% with postoperative antibiotics > 24 hours (p = 0.008). CONCLUSIONS Although the incidence of all-type SSI was highest in the antibiotics > 24 hours cohort, which also had the highest proportions of risk factors, duration of antibiotics failed to predict all-type SSI. On multinomial subanalysis, administration of postoperative antibiotics for both ≤ 24 hours and > 24 hours was associated with decreased risk of only deep SSI but not superficial SSI. Spine surgeons can safely consider antibiotics for 24 hours, which is equally as effective as long-term administration for prophylaxis against deep SSI.

Surgical site infection prevention through bundled interventions in hip replacement surgery: A systematic review

2021 ◽  
pp. 106149
Author(s):  
Costanza Vicentini ◽  
Valerio Bordino ◽  
Alessandro Roberto Cornio ◽  
Ilaria Canta ◽  
Noemi Marengo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Surgical Site Infection ◽  
Hip Replacement ◽  
Infection Prevention ◽  
Site Infection ◽  
Replacement Surgery ◽  
Hip Replacement Surgery

Use of surgical-site infection rates to rank hospital performance across several types of surgery

2013 ◽  
Vol 100 (5) ◽  
pp. 628-637 ◽  
Author(s):  
A. M. van Dishoeck ◽  
M. B. G. Koek ◽  
E. W. Steyerberg ◽  
B. H. B. van Benthem ◽  
M. C. Vos ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Hospital Performance ◽  
Site Infection ◽  
Infection Rates

Standardized incidence rates of surgical site infection: A multicenter study in Thailand

2005 ◽  
Vol 33 (10) ◽  
pp. 587-594 ◽  
Author(s):  
Nongyao Kasatpibal ◽  
Silom Jamulitrat ◽  
Virasakdi Chongsuvivatwong
Keyword(s):  
Surgical Site Infection ◽  
Multicenter Study ◽  
Incidence Rates ◽  
Site Infection
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