The Impacts of Deep Surgical Site Infections on Readmissions, Length of Stay, and Costs: A Matched Case-Control Study Conducted in an Academic Hospital in the Netherlands

Overview

Journal Infect Drug Resist

Publisher Dove Medical Press

Date 2020 Oct 16

PMID 33061483

Citations 1

Authors

Abdul Khairul Rizki Purba

Christian F Luz

Riyanti R Wulandari

Ieneke van der Gun

Jan-Willem Dik

Alex W Friedrich

Maarten J Postma

Affiliations

Soon will be listed here.

Abstract

Objective: This study aimed to evaluate the impacts of deep surgical site infections (dSSIs) regarding hospital readmissions, prolonged length of stay (LoS), and estimated costs.

Patients And Methods: We designed and applied a matched case-control observational study using the electronic health records at the University Medical Center Groningen in the Netherlands. We compared patients with dSSI and non-SSI, matched on the basis of having similar procedures. A prevailing topology of surgeries categorized as clean, clean-contaminated, contaminated, and dirty was applied.

Results: Out of a total of 12,285 patients, 393 dSSI were identified as cases, and 2864 patients without SSIs were selected as controls. A total of 343 dSSI patients (87%) and 2307 (81%) controls required hospital readmissions. The median LoS was 7 days (P-P: 2.5-14.5) for dSSI patients and 5 days (P-P: 1-9) for controls (-value: <0.001). The estimated mean cost per hospital admission was €9,016 (SE±343) for dSSI patients and €5,409 (SE±120) for controls (p<0.001). Independent variables associated with dSSI were patient's age ≥65 years (OR: 1.334; 95% CI: 1.036-1.720), the use of prophylactic antibiotics (OR: 0.424; 95% CI: 0.344-0.537), and neoplasms (OR: 2.050; 95% CI: 1.473-2.854).

Conclusion: dSSI is associated with increased costs, prolonged LoS, and increased readmission rates. Elevated risks were seen for elderly patients and those with neoplasms. Additionally, a protective effect of prophylactic antibiotics was found.

Citing Articles

Knowledge, attitude, and practice of surgical site infection prevention among operating room nurses in southwest China.

Feng W, Sae-Sia W, Kitrungrote L Belitung Nurs J. 2023; 8(2):124-131.

PMID: 37521896 PMC: 10386800. DOI: 10.33546/bnj.2018.

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