scholarly journals Ranking Hospitals Based on Colon Surgery and Abdominal Hysterectomy Surgical Site Infection Outcomes: Impact of Limiting Surveillance to the Operative Hospital

2018 ◽  
Vol 67 (7) ◽  
pp. 1096-1102 ◽  
Author(s):  
Deborah S Yokoe ◽  
Taliser R Avery ◽  
Richard Platt ◽  
Ken Kleinman ◽  
Susan S Huang
Keyword(s):  
Surgical Site Infection ◽  
Colon Surgery ◽  
Abdominal Hysterectomy ◽  
Site Infection

scholarly journals Variable Case Detection and Many Unreported Cases of Surgical-Site Infection Following Colon Surgery and Abdominal Hysterectomy in a Statewide Validation

2017 ◽  
Vol 38 (9) ◽  
pp. 1091-1097 ◽  
Author(s):  
Michael S. Calderwood ◽  
Susan S. Huang ◽  
Vicki Keller ◽  
Christina B. Bruce ◽  
N. Neely Kazerouni ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Chart Review ◽  
External Validation ◽  
Colon Surgery ◽  
Abdominal Hysterectomy ◽  
Site Infection ◽  
California Department ◽  
Added Benefit ◽  
Infection Preventionists ◽  
Traditional Surveillance

OBJECTIVETo assess hospital surgical-site infection (SSI) identification and reporting following colon surgery and abdominal hysterectomy via a statewide external validationMETHODSInfection preventionists (IPs) from the California Department of Public Health (CDPH) performed on-site SSI validation for surgical procedures performed in hospitals that voluntarily participated. Validation involved chart review of SSI cases previously reported by hospitals plus review of patient records flagged for review by claims codes suggestive of SSI. We assessed the sensitivity of traditional surveillance and the added benefit of claims-based surveillance. We also evaluated the positive predictive value of claims-based surveillance (ie, workload efficiency).RESULTSUpon validation review, CDPH IPs identified 239 SSIs following colon surgery at 42 hospitals and 76 SSIs following abdominal hysterectomy at 34 hospitals. For colon surgery, traditional surveillance had a sensitivity of 50% (47% for deep incisional or organ/space [DI/OS] SSI), compared to 84% (88% for DI/OS SSI) for claims-based surveillance. For abdominal hysterectomy, traditional surveillance had a sensitivity of 68% (67% for DI/OS SSI) compared to 74% (78% for DI/OS SSI) for claims-based surveillance. Claims-based surveillance was also efficient, with 1 SSI identified for every 2 patients flagged for review who had undergone abdominal hysterectomy and for every 2.6 patients flagged for review who had undergone colon surgery. Overall, CDPH identified previously unreported SSIs in 74% of validation hospitals performing colon surgery and 35% of validation hospitals performing abdominal hysterectomy.CONCLUSIONSClaims-based surveillance is a standardized approach that hospitals can use to augment traditional surveillance methods and health departments can use for external validation.Infect Control Hosp Epidemiol 2017;38:1091–1097

Impact of preoperative anxiolytic on surgical site infection in patients undergoing abdominal hysterectomy

2008 ◽  
Vol 36 (10) ◽  
pp. 718-726 ◽  
Author(s):  
Rosa Levandovski ◽  
Maria Beatriz Cardoso Ferreira ◽  
Maria Paz Loayza Hidalgo ◽  
Cássio Alves Konrath ◽  
Daniel Lemons da Silva ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Abdominal Hysterectomy ◽  
Site Infection

scholarly journals Risk factors for surgical site infection in colon surgery in our population

2018 ◽  
Vol 75 (4) ◽  
pp. 229
Author(s):  
Santiago Olguín Joseau ◽  
Natalia Paola Bollati ◽  
Santiago Reimondez ◽  
Franco Signorini ◽  
Alejandro Mario Rossini ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Odds Ratio ◽  
Colon Surgery ◽  
Site Infection ◽  
Quimioterapia Neoadyuvante ◽  
Factores De Riesgo

<p>Introducción: La infección de sitio quirúrgico (ISQ) es la infección intrahospitalaria más frecuente en los pacientes quirúrgicos con una incidencia entre 5-30%. Objetivos: Identificar los factores de riesgo para ISQ en cirugía colónica en nuestra población. Los objetivos secundarios son determinar la incidencia y tipo de ISQ, así como la incidencia de dehiscencia de anastomosis (DA). Materiales y métodos: Estudio de casos-controles de pacientes intervenidos de colectomía entre 2010-2014 en el Hospital Privado Universitario de Córdoba y Hospital Raúl Ferreyra. Se incluyeron las intervenciones convencionales y laparoscópicas, con seguimiento de 30 días, pacientes entre 20 y 85 años y con ASA I-III. Se excluyeron las cirugías de urgencia y las resecciones recto-anales. Se definió ISQ a aquella que ocurre dentro de 30 días. Resultados: Se incluyeron 238 pacientes. Se diagnosticó ISQ en 27,7% (n=66) de los pacientes de los cuales 12,2% fue superficial, 4,6% profunda y 10,9% de órgano/espacio. El análisis multivariado demostró que la ISQ se asocia con sexo masculino (odds ratio [OR] 3,15; IC95%:1,43-6,92; p=0,004), quimioterapia neoadyuvante (OR 6,72; IC95%:1,48-30,93; p=0,01), conversión (OR 3,32; IC95%:1,13-9,77; p=0,02), reintervención dentro de 30 días postquirúrgicos (OR 12,34; IC95%:2,65-57,37, p=0,001) y DA (OR 12,83; IC95%:2,97- 55,5; p=0,001). La DA presenta una incidencia del 9,6%, de los cuales el 91% presentó ISQ y todas fueron de órgano/espacio. Conclusión: Sexo masculino, quimioterapia neoadyuvante, conversión, reintervención dentro de 30 días postquirúrgicos y DA son factores de riesgo para ISQ en nuestra población. Estos resultados deben ser considerados para implementar medidas preventivas para ISQ.</p>

scholarly journals Developing a Risk Stratification Model for Surgical Site Infection after Abdominal Hysterectomy

2009 ◽  
Vol 30 (11) ◽  
pp. 1077-1083 ◽  
Author(s):  
Margaret A. Olsen ◽  
James Higham-Kessler ◽  
Deborah S. Yokoe ◽  
Anne M. Butler ◽  
Johanna Vostok ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Insurance ◽  
Blood Transfusion ◽  
Risk Stratification ◽  
Surgical Site Infection ◽  
Private Health Insurance ◽  
Abdominal Hysterectomy ◽  
Site Infection ◽  
Independent Risk Factors ◽  
Duration Of Operation

Objective.The incidence of surgical site infection (SSI) after hysterectomy ranges widely from 2% to 21%. A specific risk stratification index could help to predict more accurately the risk of incisional SSI following abdominal hysterectomy and would help determine the reasons for the wide range of reported SSI rates in individual studies. To increase our understanding of the risk factors needed to build a specific risk stratification index, we performed a retrospective multihospital analysis of risk factors for SSI after abdominal hysterectomy.Methods.Retrospective case-control study of 545 abdominal and 275 vaginal hysterectomies from July 1, 2003, to June 30, 2005, at 4 institutions. SSIs were defined by using Centers for Disease Control and Prevention/National Nosocomial Infections Surveillance criteria. Independent risk factors for abdominal hysterectomy were identified by using logistic regression.Results.There were 13 deep incisional, 53 superficial incisional, and 18 organ-space SSIs after abdominal hysterectomy and 14 organ-space SSIs after vaginal hysterectomy. Because risk factors for organ-space SSI were different according to univariate analysis, we focused further analyses on incisional SSI after abdominal hysterectomy. The maximum serum glucose level within 5 days after operation was highest in patients with deep incisional SSI, lower in patients with superficial incisional SSI, and lowest in uninfected patients (median, 189, 156, and 141 mg/dL, respectively; P = .005). Independent risk factors for incisional SSI included blood transfusion (odds ratio [OR], 2.4) and morbid obesity (body mass index [BMI], >35; OR, 5.7). Duration of operation greater than the 75th percentile (OR, 1.7), obesity (BMI, 30–35; OR, 3.0), and lack of private health insurance (OR, 1.7) were marginally associated with increased odds of SSI.Conclusions.Incisional SSI after abdominal hysterectomy was associated with increased BMI and blood transfusion. Longer duration of operation and lack of private health insurance were marginally associated with SSI.

scholarly journals 909Comparison of three different data sources for Surgical Site Infection (SSI) Surveillance after Colon Surgery

2014 ◽  
Vol 1 (suppl_1) ◽  
pp. S262-S262
Author(s):  
Teresa Childers ◽  
Shauna C Usiak ◽  
Mindy Sovel ◽  
Luke Selby ◽  
Vivian Strong ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Colon Surgery ◽  
Data Sources ◽  
Site Infection

scholarly journals First Results of the Swiss National Surgical Site Infection Surveillance Program: Who Seeks Shall Find

2017 ◽  
Vol 38 (06) ◽  
pp. 697-704 ◽  
Author(s):  
Nicolas Troillet ◽  
Emin Aghayev ◽  
Marie-Christine Eisenring ◽  
Andreas F. Widmer ◽  
Keyword(s):  
Surgical Site Infection ◽  
Temporal Trends ◽  
Colon Surgery ◽  
Surveillance Program ◽  
Site Infection ◽  
Post Discharge ◽  
Public And Private ◽  
Logistic Regression Models ◽  
First Results ◽  
The Impact

OBJECTIVES To report on the results of the Swiss national surgical site infection (SSI) surveillance program, including temporal trends, and to describe methodological characteristics that may influence SSI rates DESIGN Countrywide survey of SSI over a 4-year period. Analysis of prospectively collected data including patient and procedure characteristics as well as aggregated SSI rates stratified by risk categories, type of SSI, and time of diagnosis. Temporal trends were analyzed using stepwise multivariate logistic regression models with adjustment of the effect of the duration of participation in the surveillance program for confounding factors. SETTING The study included 164 Swiss public and private hospitals with surgical activities. RESULTS From October 2011 to September 2015, a total of 187,501 operations performed in this setting were included. Cumulative SSI rates varied from 0.9% for knee arthroplasty to 14.4% for colon surgery. Postdischarge follow-up was completed in &gt;90% of patients at 1 month for surgeries without an implant and in &gt;80% of patients at 12 months for surgeries with an implant. High rates of SSIs were detected postdischarge, from 20.7% in colon surgeries to 93.3% in knee arthroplasties. Overall, the impact of the duration of surveillance was significantly and independently associated with a decrease in SSI rates in herniorraphies and C-sections but not for the other procedures. Nevertheless, some hospitals observed significant decreases in their rates for various procedures. CONCLUSIONS Intensive post-discharge surveillance may explain high SSI rates and cause artificial differences between programs. Surveillance per se, without structured and mandatory quality improvement efforts, may not produce the expected decrease in SSI rates. Infect Control Hosp Epidemiol 2017;38:697–704

Sustained Reduction in Surgical Site Infection after Abdominal Hysterectomy

2013 ◽  
Vol 14 (5) ◽  
pp. 460-463 ◽  
Author(s):  
Heather Young ◽  
Bryan Knepper ◽  
Cathy Vigil ◽  
Amber Miller ◽  
J. Chris Carey ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Abdominal Hysterectomy ◽  
Site Infection ◽  
Sustained Reduction

scholarly journals Incidence and risk factors of surgical site infection following colorectal surgery in Iran: a prospective cohort study

2021 ◽  
Author(s):  
Siamak Rajaei ◽  
Masoud Mohammadi ◽  
Mohammad Hosein Taziki Balajelini ◽  
Reza Afghani ◽  
Mehrshad Zare ◽  
...  
Keyword(s):  
Risk Factors ◽  
Colorectal Surgery ◽  
Surgical Site Infection ◽  
Colon Surgery ◽  
Site Infection ◽  
Prospective Design ◽  
Related Risk ◽  
Scientific Principles ◽  
Golestan Province ◽  
Univariate Analyses

Abstract Background Surgical site infection (SSI) after colorectal surgery remains a significant problem for its negative clinical outcomes. The aim of this study was to determine the incidence of SSI after colorectal surgery in 5-Azar hospital of Gorgan, Golestan province, Iran and to further evaluate the related risk factors. Methods A prospective design was applied. Patients in the 5-Azar hospital of Gorgan, Golestan province, Iran was prospectively monitored for SSI after colorectal surgery. The demographic and perioperative characteristics were collected, and the main outcome were SSI within postoperative 30 days. Univariate analyses were used to identify risk factors. Results A total of 240 patients were enrolled in the study and the overall SSI rate was 23.3% (56 patients). Univariate analyses indicated that corticosteroids use (Risk Ratio (RR) = 3, 95% CI: 1.62–5.54), segmental resection with anastomosis (RR = 2.28, 95% CI: 1.12–4.63), anemia (RR = 4.52, 95% CI: 3.11–6.59), diabetics (RR = 2.68, 95% CI: 1.73–4.14), and opium use (RR = 1.87, 95% CI: 1.17–2.99) are risk factors for SSI. Conclusions SSI still seems to be a problem in colon surgery despite the observance of scientific principles. There are some risk factors for SSI that can be prevented.

Protocol-Driven Reduction in Surgical Site Infection after Colon Surgery

2018 ◽  
Vol 227 (4) ◽  
pp. e111
Author(s):  
Carolina Martinez ◽  
Nkechinye P. Omesiete ◽  
Viraj Pandit ◽  
Yadira Villalvazo ◽  
Meleesa Nocera ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Colon Surgery ◽  
Site Infection
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