E Limón1, E Shaw2, J M Badia3, M Piriz4, R Escofet5, F Gudiol6, M Pujol7. 1. VINCat Coordinator Center, Barcelona, Spain. 2. Hospital Universitari de Bellvitge, Barcelona, Spain; Spanish Network for the Research in Infectious Diseases, Instituto de Salud Carlos III, Madrid, Spain. 3. Hospital General de Granollers, Granollers, Spain. 4. Corporació Sanitària Parc Taulí, Barcelona, Spain. 5. Hospital Universitari de Bellvitge, Barcelona, Spain. 6. VINCat Coordinator Center, Barcelona, Spain; Hospital Universitari de Bellvitge, Barcelona, Spain; Spanish Network for the Research in Infectious Diseases, Instituto de Salud Carlos III, Madrid, Spain. 7. VINCat Coordinator Center, Barcelona, Spain; Hospital Universitari de Bellvitge, Barcelona, Spain; Spanish Network for the Research in Infectious Diseases, Instituto de Salud Carlos III, Madrid, Spain. Electronic address: mpujol@bellvitgehospital.cat.
Abstract
BACKGROUND: Surgical site infection (SSI) after colorectal procedures represents a measurable quality indicator of a healthcare system. There is an increasing interest in comparing SSI rates between different hospitals and countries: however, the variability of the data regarding the incidence of SSI makes this comparison difficult. For the purposes of evaluation, data collection must be standardized and must include reliable post-discharge surveillance (PDS). AIM: To determine impact and risk factors for PDS SSI after elective colorectal surgery. METHODS: VINCat is a nosocomial infection surveillance programme in Catalonia, Spain. Between 2007 and 2011, 52 hospitals joined the programme. Hospitals performed active, prospective, standardized surveillance of elective colorectal resection. PDS was implemented by a multimodal approach and was mandatory within the first 30 days after surgery. FINDINGS: During the study period, 13,661 elective colorectal procedures were included. SSI was diagnosed in 2826 (20.7%) patients, of whom 22.5% during PDS; of these, 52% required readmission. Patients with PDS SSI were younger (odds ratio: 1.57; 95% confidence interval: 1.29-1.91), predominantly female (1.40; 1.16-1.69), had more frequently undergone endoscopic procedures (1.56; 1.30-1.88) and had more incisional SSI (1.88; 1.54-2.28) than patients with in-hospital SSI. CONCLUSION: SSI rates in elective colorectal procedures at VINCat hospitals were inside the higher range of those reported by other national programmes. PDS SSI increased the overall rate of SSI, had a significant clinical impact, and accounted for almost a quarter of SSI. Younger age and laparoscopic procedures were the most relevant risk factors. Standardized multimodal PDS should be implemented for hospitals performing surveillance of colorectal surgery.
BACKGROUND: Surgical site infection (SSI) after colorectal procedures represents a measurable quality indicator of a healthcare system. There is an increasing interest in comparing SSI rates between different hospitals and countries: however, the variability of the data regarding the incidence of SSI makes this comparison difficult. For the purposes of evaluation, data collection must be standardized and must include reliable post-discharge surveillance (PDS). AIM: To determine impact and risk factors for PDS SSI after elective colorectal surgery. METHODS: VINCat is a nosocomial infection surveillance programme in Catalonia, Spain. Between 2007 and 2011, 52 hospitals joined the programme. Hospitals performed active, prospective, standardized surveillance of elective colorectal resection. PDS was implemented by a multimodal approach and was mandatory within the first 30 days after surgery. FINDINGS: During the study period, 13,661 elective colorectal procedures were included. SSI was diagnosed in 2826 (20.7%) patients, of whom 22.5% during PDS; of these, 52% required readmission. Patients with PDS SSI were younger (odds ratio: 1.57; 95% confidence interval: 1.29-1.91), predominantly female (1.40; 1.16-1.69), had more frequently undergone endoscopic procedures (1.56; 1.30-1.88) and had more incisional SSI (1.88; 1.54-2.28) than patients with in-hospital SSI. CONCLUSION: SSI rates in elective colorectal procedures at VINCat hospitals were inside the higher range of those reported by other national programmes. PDS SSI increased the overall rate of SSI, had a significant clinical impact, and accounted for almost a quarter of SSI. Younger age and laparoscopic procedures were the most relevant risk factors. Standardized multimodal PDS should be implemented for hospitals performing surveillance of colorectal surgery.
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Authors: A Gomila; J Carratalà; J M Badia; D Camprubí; M Piriz; E Shaw; V Diaz-Brito; E Espejo; C Nicolás; M Brugués; R Perez; A Lérida; A Castro; S Biondo; D Fraccalvieri; E Limón; F Gudiol; M Pujol Journal: BMC Infect Dis Date: 2018-10-05 Impact factor: 3.090
Authors: Janneke D M Verberk; Stephanie M van Rooden; David J Hetem; Herman F Wunderink; Anne L M Vlek; Corianne Meijer; Eva A H van Ravensbergen; Elisabeth G W Huijskens; Saara J Vainio; Marc J M Bonten; Maaike S M van Mourik Journal: Antimicrob Resist Infect Control Date: 2022-01-21 Impact factor: 4.887