OBJECTIVE: To evaluate the time trend in the surgical site infection (SSI) rate in relation to the duration of surveillance in The Netherlands. SETTING: Forty-two hospitals that participated in the the Dutch national nosocomial surveillance network, which is known as PREZIES (Preventie van Ziekenhuisinfecties door Surveillance), and that registered at least 1 of the following 5 frequently performed surgical procedures for at least 3 years during the period from 1996 through 2006: mastectomy, colectomy, replacement of the head of the femur, total hip arthroplasty, or knee arthroplasty. METHODS: Analyses were performed for each surgical procedure. The surveillance time to operation was stratified in consecutive 1-year periods, with the first year as reference. Multivariate logistic regression analysis was performed using a random coefficient model to adjust for random variation among hospitals. All models were adjusted for method of postdischarge surveillance. RESULTS: The number of procedures varied from 3,031 for colectomy to 31,407 for total hip arthroplasty, and the SSI rate varied from 1.6% for knee arthroplasty to 12.2% for colectomy. For total hip arthroplasty, the SSI rate decreased significantly by 6% per year of surveillance (odds ratio [OR], 0.94 [95% confidence interval {CI}, 0.90-0.98]), indicating a 60% decrease after 10 years. Nonsignificant but substantial decreasing trends in the rate of SSI were found for replacement of the head of the femur (OR, 0.94 [95% CI, 0.88-1.00]) and for colectomy (OR, 0.92 [95% CI, 0.83-1.02]). CONCLUSIONS: Even though most decreasing trends in the SSI rate were not statistically significant, they were encouraging. To use limited resources as efficiently as possible, we would suggest switching the surveillance to another surgical procedure when the SSI rate for that particular procedure has decreased below the target rate.
OBJECTIVE: To evaluate the time trend in the surgical site infection (SSI) rate in relation to the duration of surveillance in The Netherlands. SETTING: Forty-two hospitals that participated in the the Dutch national nosocomial surveillance network, which is known as PREZIES (Preventie van Ziekenhuisinfecties door Surveillance), and that registered at least 1 of the following 5 frequently performed surgical procedures for at least 3 years during the period from 1996 through 2006: mastectomy, colectomy, replacement of the head of the femur, total hip arthroplasty, or knee arthroplasty. METHODS: Analyses were performed for each surgical procedure. The surveillance time to operation was stratified in consecutive 1-year periods, with the first year as reference. Multivariate logistic regression analysis was performed using a random coefficient model to adjust for random variation among hospitals. All models were adjusted for method of postdischarge surveillance. RESULTS: The number of procedures varied from 3,031 for colectomy to 31,407 for total hip arthroplasty, and the SSI rate varied from 1.6% for knee arthroplasty to 12.2% for colectomy. For total hip arthroplasty, the SSI rate decreased significantly by 6% per year of surveillance (odds ratio [OR], 0.94 [95% confidence interval {CI}, 0.90-0.98]), indicating a 60% decrease after 10 years. Nonsignificant but substantial decreasing trends in the rate of SSI were found for replacement of the head of the femur (OR, 0.94 [95% CI, 0.88-1.00]) and for colectomy (OR, 0.92 [95% CI, 0.83-1.02]). CONCLUSIONS: Even though most decreasing trends in the SSI rate were not statistically significant, they were encouraging. To use limited resources as efficiently as possible, we would suggest switching the surveillance to another surgical procedure when the SSI rate for that particular procedure has decreased below the target rate.
Authors: Tjallie van der Kooi; Hugo Sax; Didier Pittet; Jaap van Dissel; Birgit van Benthem; Bernhard Walder; Vanessa Cartier; Lauren Clack; Sabine de Greeff; Martin Wolkewitz; Stefanie Hieke; Hendriek Boshuizen; Jan van de Kassteele; Annemie Van den Abeele; Teck Wee Boo; Magda Diab-Elschahawi; Uga Dumpis; Camelia Ghita; Susan FitzGerald; Tatjana Lejko; Kris Leleu; Mercedes Palomar Martinez; Olga Paniara; Márta Patyi; Paweł Schab; Annibale Raglio; Emese Szilágyi; Mirosław Ziętkiewicz; Albert W Wu; Hajo Grundmann; Walter Zingg Journal: Intensive Care Med Date: 2017-12-16 Impact factor: 17.440
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: Jeffery Ho; Jacques F Meis; Marrigje Nabuurs-Franssen; Andreas Voss Journal: Antimicrob Resist Infect Control Date: 2015-05-15 Impact factor: 4.887
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