![]() ![]() ![]() As many as 60 percent of SSIs are considered to be preventable. With an annual estimated overall cost of $3 to $5 billion in the U.S., SSIs are associated with a nearly 10-day increased length of stay and an increase of $20,000 in the cost of hospitalization per admission. Furthermore, SSIs are the most costly of all hospital-acquired infections. Although most patients recover from an SSI without any long-term consequences, they are at a two- to 11-fold increased risk of mortality. SSIs account for 20 percent of all infections that occur in the hospital setting. Research indicates that SSIs are the most common type of hospital-acquired infection. Surgery also presents a significant risk to patients, and together, the operating room should be on the infection preventionist's radar for healthcare-associated infection (HAI) mitigation and elimination. Now that the Centers for Medicare and Medicaid Services no longer pays additional amounts for the cost of treating conditions acquired in a hospital, SSIs have been targeted not only to improve clinical quality, but also to protect hospital reimbursement.Ī hospital's surgical services department represents one of the most sizable challenges to infection prevention and control. With an annual estimated overall cost of $3 billion to $5 billion in the U.S., SSIs are associated with a nearly 10-day increased length of stay and an increase of $20,000 in the cost of hospitalization per admission. All rights reserved.A hospital's surgical services department represents one of the most sizable challenges to infection prevention and control. They represent an important hidden burden in our healthcare system.Ĭopyright 2010 The Hospital Infection Society. Post-discharge SSIs are frequent, severe, scattered over time and location, and hard to predict using common risk indices. Predictors of post-discharge infection included shorter procedure duration, shorter length of stay, rural residence, alcoholism, diabetes and obesity. Patients with post-discharge infections had baseline characteristics more akin to uninfected patients than patients with in-hospital infections. The most common risk index predicted incremental increases in the risk of in-hospital SSI, but did not predict increases in the risk of post-discharge infection. Post-discharge infections were associated with an increased risk of reoperation (odds ratio: 2.28 95% confidence interval: 2.11-2.48), return emergency room visit (9.08 8.89-9.27), and readmission (6.16 5.98-6.35). The cohort included 622 683 patients, of whom 84 081 (13.5%) were diagnosed with SSI, and more than half (48 725) were diagnosed post-discharge. The 30 day risk of SSI was derived from the initial hospital admission, outpatient consultations, return emergency room visits and readmissions. Procedure and patient characteristics were derived from linked hospital, emergency room and physician claims databases within Canada's universal healthcare system. ![]() We evaluated all patients admitted for their first elective surgical procedure in Ontario, Canada, between 1 April 2002 and 31 March 2008. In this population-based retrospective cohort study, we examined the frequency, severity, and prediction of post-discharge surgical site infections (SSIs). ![]()
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