An interventional nationwide surveillance program lowers postoperative infection rates in elective colorectal surgery. A cohort study (2008-2019)
Por:
Arroyo-Garcia N., Badia J.M., Vázquez A., Pera M., Parés D., Limón E., Almendral A., Piriz M., Díez C., Fraccalvieri D., López-Contreras J., Pujol M., VINCat Program
Publicada:
1 jun 2022
Ahead of Print:
1 may 2022
Resumen:
Background: Colorectal surgery is associated with the highest rate of surgical site infection (SSI). This study analyses the effectiveness of an interventional surveillance program on SSI rates after elective colorectal surgery. Material and methods: Cohort study showing temporal trends of SSI rates and Standardized Infection Ratio (SIR) in elective colorectal surgery over a 12-year period. Prospectively collected data of a national SSI surveillance program was analysed and the effect of specific interventions was evaluated. Patient and procedure characteristics, as well as SIR and SSI rates were stratified by risk categories and type of SSI analysed using stepwise multivariate logistic regression models. Results: In a cohort of 42,330 operations, overall cumulative SSI incidence was 16.31%, and organ-space SSI (O/ S-SSI) was 8.59%. There was a 61.63% relative decrease in SSI rates (rho = -0.95804). The intervention which achieved the greatest SSI reduction was a bundle of 6 measures. SSI in pre-bundle period was 19.73% vs. 11.10% in post-bundle period (OR 1.969; IC 95% 1.860-2.085; p < 0.0001). O/S-SSI were 9.08% vs. 6.06%, respectively (OR 1.547; IC 95% 1.433-1.670; p < 0.0001). Median length of stay was 7 days, with a significant decrease over the studied period (rho = -0.98414). Mortality of the series was 1.08%, ranging from 0.35% to 2.0%, but a highly significant decrease was observed (rho = -0.67133). Conclusions: Detailed analysis of risk factors and postoperative infection in colorectal surgery allows strategies for reducing SSI incidence to be designed. An interventional surveillance program has been effective in decreasing SIR and SSI rates.
Filiaciones:
Arroyo-Garcia N.:
Department of Surgery, Hospital General Granollers, School of Medicine, Universitat Internacional de Catalunya, Granollers, Spain
Badia J.M.:
Department of Surgery, Hospital General Granollers, School of Medicine, Universitat Internacional de Catalunya, Granollers, Spain
Vázquez A.:
Servei d'Estadística Aplicada, Universitat Autònoma de Barcelona, Spain
Pera M.:
Department of Surgery, Hospital del Mar, Barcelona, Spain
Parés D.:
Department of Surgery, Hospital Universitari Germans Trias i Pujol. Badalona, Spain
Limón E.:
VINCat Program, Universitat de Barcelona, Catalonia, Spain
Almendral A.:
VINCat Program, Catalonia, Spain
Piriz M.:
Infection Control Team. Hospital Universitari Sant Pau. Barcelona, Spain
Díez C.:
Department of Anaesthesiology. Hospital Universitari Sant Pau. Barcelona, Spain
Fraccalvieri D.:
Department of Surgery, Hospital Universitari de Bellvitge. L'Hospitalet de Llobregat, Spain
López-Contreras J.:
Infectious Disease Unit, Hospital de la Santa Creu i Sant Pau–Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain
Pujol M.:
VINCat Program, Catalonia, Spain
Department of Infectious Diseases, Hospital Universitari de Bellvitge. L'Hospitalet de Llobregat, Spain, Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain, VINCat Program, Catalonia, Spain
VINCat Program:
VINCat Program, Universitat de Barcelona, Catalonia, Spain
hybrid, Hybrid Gold
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