OBJECTIVE: To evaluate the impact of postdischarge surveillance on surgical site infection (SSI) rates after orthopedic surgery. SETTING: Nine hospitals participating in the Finnish Hospital Infection Program. PATIENTS: All patients who underwent hip or knee arthroplasty or open reduction of a femur fracture during 1999-2002. RESULTS: The date of discharge was available for 11,812 procedures (90%). The median length of hospital stay was 8 days (range per hospital, 6-9 days). The overall SSI rate was 3.3% (range, 0.8%-6.4%). Of 384 SSIs detected, 216 (56%; range, 28%-90%) were detected after discharge: 93 (43%) were detected on readmission to the hospital, 73 (34%) at completion of a postdischarge questionnaire, and 23 (11%) at a follow-up visit. For 27 postdischarge SSIs (13%), the location of detection was unknown. Altogether, 32 (86%) of 37 of organ/space SSIs, 57 (80%) of 71 deep incisional SSIs, and 127 (46%) of 276 superficial incisional SSIs were detected after discharge. Most SSIs (70%) detected on readmission were severe (organ/space or deep incisional), whereas most SSIs (86%) detected at follow-up visits or at completion of a postdischarge questionnaire were superficial. Of all SSIs, 78% (range, 48%-100%) were microbiologically confirmed. Microbiologic confirmation was less common after discharge than during postoperative hospital stay (66% vs 93%; P<.001). CONCLUSIONS: Postdischarge surveillance had a large impact on the rate of SSI detected after orthopedic surgery. However, postdischarge surveillance conducted by means of a questionnaire detected only a minority of deep incisional and organ/space SSIs.
OBJECTIVE: To evaluate the impact of postdischarge surveillance on surgical site infection (SSI) rates after orthopedic surgery. SETTING: Nine hospitals participating in the Finnish Hospital Infection Program. PATIENTS: All patients who underwent hip or knee arthroplasty or open reduction of a femur fracture during 1999-2002. RESULTS: The date of discharge was available for 11,812 procedures (90%). The median length of hospital stay was 8 days (range per hospital, 6-9 days). The overall SSI rate was 3.3% (range, 0.8%-6.4%). Of 384 SSIs detected, 216 (56%; range, 28%-90%) were detected after discharge: 93 (43%) were detected on readmission to the hospital, 73 (34%) at completion of a postdischarge questionnaire, and 23 (11%) at a follow-up visit. For 27 postdischarge SSIs (13%), the location of detection was unknown. Altogether, 32 (86%) of 37 of organ/space SSIs, 57 (80%) of 71 deep incisional SSIs, and 127 (46%) of 276 superficial incisional SSIs were detected after discharge. Most SSIs (70%) detected on readmission were severe (organ/space or deep incisional), whereas most SSIs (86%) detected at follow-up visits or at completion of a postdischarge questionnaire were superficial. Of all SSIs, 78% (range, 48%-100%) were microbiologically confirmed. Microbiologic confirmation was less common after discharge than during postoperative hospital stay (66% vs 93%; P<.001). CONCLUSIONS: Postdischarge surveillance had a large impact on the rate of SSI detected after orthopedic surgery. However, postdischarge surveillance conducted by means of a questionnaire detected only a minority of deep incisional and organ/space SSIs.
Authors: Tahir Mahmud; Matthew C Lyons; Douglas D Naudie; Steven J Macdonald; Richard W McCalden Journal: Clin Orthop Relat Res Date: 2012-10 Impact factor: 4.176
Authors: Håvard Dale; Inge Skråmm; Hege L Løwer; Hanne M Eriksen; Birgitte Espehaug; Ove Furnes; Finn Egil Skjeldestad; Leif I Havelin; Lars B Engesaeter Journal: Acta Orthop Date: 2011-11-09 Impact factor: 3.717
Authors: Håvard Dale; Anne M Fenstad; Geir Hallan; Leif I Havelin; Ove Furnes; Søren Overgaard; Alma B Pedersen; Johan Kärrholm; Göran Garellick; Pekka Pulkkinen; Antti Eskelinen; Keijo Mäkelä; Lars B Engesæter Journal: Acta Orthop Date: 2012-10 Impact factor: 3.717