scholarly journals Variable Case Detection and Many Unreported Cases of Surgical-Site Infection Following Colon Surgery and Abdominal Hysterectomy in a Statewide Validation

2017 ◽  
Vol 38 (9) ◽  
pp. 1091-1097 ◽  
Author(s):  
Michael S. Calderwood ◽  
Susan S. Huang ◽  
Vicki Keller ◽  
Christina B. Bruce ◽  
N. Neely Kazerouni ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Chart Review ◽  
External Validation ◽  
Colon Surgery ◽  
Abdominal Hysterectomy ◽  
Site Infection ◽  
California Department ◽  
Added Benefit ◽  
Infection Preventionists ◽  
Traditional Surveillance

OBJECTIVETo assess hospital surgical-site infection (SSI) identification and reporting following colon surgery and abdominal hysterectomy via a statewide external validationMETHODSInfection preventionists (IPs) from the California Department of Public Health (CDPH) performed on-site SSI validation for surgical procedures performed in hospitals that voluntarily participated. Validation involved chart review of SSI cases previously reported by hospitals plus review of patient records flagged for review by claims codes suggestive of SSI. We assessed the sensitivity of traditional surveillance and the added benefit of claims-based surveillance. We also evaluated the positive predictive value of claims-based surveillance (ie, workload efficiency).RESULTSUpon validation review, CDPH IPs identified 239 SSIs following colon surgery at 42 hospitals and 76 SSIs following abdominal hysterectomy at 34 hospitals. For colon surgery, traditional surveillance had a sensitivity of 50% (47% for deep incisional or organ/space [DI/OS] SSI), compared to 84% (88% for DI/OS SSI) for claims-based surveillance. For abdominal hysterectomy, traditional surveillance had a sensitivity of 68% (67% for DI/OS SSI) compared to 74% (78% for DI/OS SSI) for claims-based surveillance. Claims-based surveillance was also efficient, with 1 SSI identified for every 2 patients flagged for review who had undergone abdominal hysterectomy and for every 2.6 patients flagged for review who had undergone colon surgery. Overall, CDPH identified previously unreported SSIs in 74% of validation hospitals performing colon surgery and 35% of validation hospitals performing abdominal hysterectomy.CONCLUSIONSClaims-based surveillance is a standardized approach that hospitals can use to augment traditional surveillance methods and health departments can use for external validation.Infect Control Hosp Epidemiol 2017;38:1091–1097

Validation of semiautomated surgical site infection surveillance using electronic screening algorithms in 38 surgery categories

2018 ◽  
Vol 39 (8) ◽  
pp. 931-935 ◽  
Author(s):  
Sun Young Cho ◽  
Doo Ryeon Chung ◽  
Jong Rim Choi ◽  
Doo Mi Kim ◽  
Si-Ho Kim ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Surveillance System ◽  
Chart Review ◽  
Medical Center ◽  
Tertiary Care ◽  
Microbial Culture ◽  
Site Infection ◽  
Electronic Screening ◽  
Sensitivity Specificity ◽  
Infection Preventionists

ObjectiveTo verify the validity of a semiautomated surgical site infection (SSI) surveillance system using electronic screening algorithms in 38 categories of surgery.DesignA cohort study for validation of semiautomated SSI surveillance system using screening algorithms.SettingA 1,989-bed tertiary-care referral center in Seoul, Republic of Korea.MethodsA dataset of 40,516 surgical procedures in 38 categories stored in the conventional SSI surveillance registry at the Samsung Medical Center between January 2013 and December 2014 was used as the reference standard. In the semiautomated surveillance system, electronic screening algorithms flagged cases meeting at least 1 of 3 criteria: antibiotic prescription, microbial culture, and infectious disease consultation. Flagged cases were audited by infection preventionists. Analyses of sensitivity, specificity, and positive predictive value (PPV) were conducted for the semiautomated surveillance system, and its effect on reducing the workload for chart review was evaluated.ResultsA total of 575 SSI events (1·42%) were identified by conventional SSI surveillance. The sensitivity of the semiautomated SSI surveillance was 96·7%, and the PPV of the screening algorithms alone was 4·1%. Semiautomated SSI surveillance reduced the chart review workload of the infection preventionists from 1,283 to 482 person hours per year (a 62·4% decrease).ConclusionsCompared to conventional surveillance, semiautomated surveillance using electronic screening algorithms followed by chart review of selected cases can provide high-validity surveillance results and can significantly reduce the workload of infection preventionists.

An Evaluation of Surgical Site Infection Surveillance Methods for Colon Surgery and Hysterectomy in Colorado Hospitals

2014 ◽  
Vol 36 (3) ◽  
pp. 353-355 ◽  
Author(s):  
Sara M. Reese ◽  
Bryan C. Knepper ◽  
Connie S. Price ◽  
Heather L. Young
Keyword(s):  
Surgical Site Infection ◽  
Online Survey ◽  
Colon Surgery ◽  
Infect Control Hosp ◽  
Healthcare Personnel ◽  
Site Infection ◽  
Laboratory Values ◽  
Infection Surveillance ◽  
Infection Preventionists

Surgical site infection (SSI) surveillance techniques for colon surgery and hysterectomy among Colorado infection preventionists were characterized through an online survey. Considerable variation was found in SSI surveillance practices, specifically varying use of triggers for SSI review, including laboratory values, healthcare personnel communication, and postoperative visits.Infect Control Hosp Epidemiol 2014;00(0): 1–3

Impact of preoperative anxiolytic on surgical site infection in patients undergoing abdominal hysterectomy

2008 ◽  
Vol 36 (10) ◽  
pp. 718-726 ◽  
Author(s):  
Rosa Levandovski ◽  
Maria Beatriz Cardoso Ferreira ◽  
Maria Paz Loayza Hidalgo ◽  
Cássio Alves Konrath ◽  
Daniel Lemons da Silva ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Abdominal Hysterectomy ◽  
Site Infection

scholarly journals Risk factors for surgical site infection in colon surgery in our population

2018 ◽  
Vol 75 (4) ◽  
pp. 229
Author(s):  
Santiago Olguín Joseau ◽  
Natalia Paola Bollati ◽  
Santiago Reimondez ◽  
Franco Signorini ◽  
Alejandro Mario Rossini ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Odds Ratio ◽  
Colon Surgery ◽  
Site Infection ◽  
Quimioterapia Neoadyuvante ◽  
Factores De Riesgo

<p>Introducción: La infección de sitio quirúrgico (ISQ) es la infección intrahospitalaria más frecuente en los pacientes quirúrgicos con una incidencia entre 5-30%. Objetivos: Identificar los factores de riesgo para ISQ en cirugía colónica en nuestra población. Los objetivos secundarios son determinar la incidencia y tipo de ISQ, así como la incidencia de dehiscencia de anastomosis (DA). Materiales y métodos: Estudio de casos-controles de pacientes intervenidos de colectomía entre 2010-2014 en el Hospital Privado Universitario de Córdoba y Hospital Raúl Ferreyra. Se incluyeron las intervenciones convencionales y laparoscópicas, con seguimiento de 30 días, pacientes entre 20 y 85 años y con ASA I-III. Se excluyeron las cirugías de urgencia y las resecciones recto-anales. Se definió ISQ a aquella que ocurre dentro de 30 días. Resultados: Se incluyeron 238 pacientes. Se diagnosticó ISQ en 27,7% (n=66) de los pacientes de los cuales 12,2% fue superficial, 4,6% profunda y 10,9% de órgano/espacio. El análisis multivariado demostró que la ISQ se asocia con sexo masculino (odds ratio [OR] 3,15; IC95%:1,43-6,92; p=0,004), quimioterapia neoadyuvante (OR 6,72; IC95%:1,48-30,93; p=0,01), conversión (OR 3,32; IC95%:1,13-9,77; p=0,02), reintervención dentro de 30 días postquirúrgicos (OR 12,34; IC95%:2,65-57,37, p=0,001) y DA (OR 12,83; IC95%:2,97- 55,5; p=0,001). La DA presenta una incidencia del 9,6%, de los cuales el 91% presentó ISQ y todas fueron de órgano/espacio. Conclusión: Sexo masculino, quimioterapia neoadyuvante, conversión, reintervención dentro de 30 días postquirúrgicos y DA son factores de riesgo para ISQ en nuestra población. Estos resultados deben ser considerados para implementar medidas preventivas para ISQ.</p>

scholarly journals Developing a Risk Stratification Model for Surgical Site Infection after Abdominal Hysterectomy

2009 ◽  
Vol 30 (11) ◽  
pp. 1077-1083 ◽  
Author(s):  
Margaret A. Olsen ◽  
James Higham-Kessler ◽  
Deborah S. Yokoe ◽  
Anne M. Butler ◽  
Johanna Vostok ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Insurance ◽  
Blood Transfusion ◽  
Risk Stratification ◽  
Surgical Site Infection ◽  
Private Health Insurance ◽  
Abdominal Hysterectomy ◽  
Site Infection ◽  
Independent Risk Factors ◽  
Duration Of Operation

Objective.The incidence of surgical site infection (SSI) after hysterectomy ranges widely from 2% to 21%. A specific risk stratification index could help to predict more accurately the risk of incisional SSI following abdominal hysterectomy and would help determine the reasons for the wide range of reported SSI rates in individual studies. To increase our understanding of the risk factors needed to build a specific risk stratification index, we performed a retrospective multihospital analysis of risk factors for SSI after abdominal hysterectomy.Methods.Retrospective case-control study of 545 abdominal and 275 vaginal hysterectomies from July 1, 2003, to June 30, 2005, at 4 institutions. SSIs were defined by using Centers for Disease Control and Prevention/National Nosocomial Infections Surveillance criteria. Independent risk factors for abdominal hysterectomy were identified by using logistic regression.Results.There were 13 deep incisional, 53 superficial incisional, and 18 organ-space SSIs after abdominal hysterectomy and 14 organ-space SSIs after vaginal hysterectomy. Because risk factors for organ-space SSI were different according to univariate analysis, we focused further analyses on incisional SSI after abdominal hysterectomy. The maximum serum glucose level within 5 days after operation was highest in patients with deep incisional SSI, lower in patients with superficial incisional SSI, and lowest in uninfected patients (median, 189, 156, and 141 mg/dL, respectively; P = .005). Independent risk factors for incisional SSI included blood transfusion (odds ratio [OR], 2.4) and morbid obesity (body mass index [BMI], >35; OR, 5.7). Duration of operation greater than the 75th percentile (OR, 1.7), obesity (BMI, 30–35; OR, 3.0), and lack of private health insurance (OR, 1.7) were marginally associated with increased odds of SSI.Conclusions.Incisional SSI after abdominal hysterectomy was associated with increased BMI and blood transfusion. Longer duration of operation and lack of private health insurance were marginally associated with SSI.

scholarly journals 909Comparison of three different data sources for Surgical Site Infection (SSI) Surveillance after Colon Surgery

2014 ◽  
Vol 1 (suppl_1) ◽  
pp. S262-S262
Author(s):  
Teresa Childers ◽  
Shauna C Usiak ◽  
Mindy Sovel ◽  
Luke Selby ◽  
Vivian Strong ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Colon Surgery ◽  
Data Sources ◽  
Site Infection
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