Impact of postdischarge surveillance on the rate of surgical site infection after orthopedic surgery.

Abstract:

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

Huotari K,Lyytikäinen O,Hospital Infection Surveillance Team.

doi

10.1086/509840

subject

Has Abstract

pub_date

2006-12-01 00:00:00

pages

1324-9

issue

12

eissn

0899-823X

issn

1559-6834

pii

S0195941700075251

journal_volume

27

pub_type

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