Prolonged Hospital Stay and Surgical-Site Infections

Aim: Aim of our study to evaluate various factors responsible for surgical site infection after gastrointestinal and hepatobiliary surgeries. Material and Methods: Patient who underwent gastrointestinal and hepatobiliary surgery in our department were evaluated retrospectively. Various factors associated with surgical site infection were evaluated using univariate and multivariate analysis. Surgical site infection was defined as any culture positive discharge from the wound within 30 days of surgery.Statistical analysis was done using SPSS version 23. Results: We evaluated total 331 patients operated between April 2018 to March 2020. 14 patients were lost to follow up after discharge and before completing post operative day 30. 18 patients expired before 30 days without developing SSI and were excluded from the study as per exclusion criteria. 299 patient included in the study. Total 20 patients developed surgical site infection. It showed SSI rate in our study population was 6.68%. On univariate analysis prolonged hospital stay, more blood product used, higher cdc grade of surgery, higher ASA grade, more operative time, open surgeries,colorectal and HPB surgeries were associated with surgical site infections. On multivariate analysis only prolonged hospital stay independently predicted Surgical Site Infectins. (p=0.014,0dds ratio 1.223, 95% confidence interal 1.042-1.435). Conclusion: Prolonged hospital stay independently predicts surgical site infections after gastrointestinal and hepatobiliary surgery.

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Prolonged Hospital Stay is Associated with Increase Surgical Site Infection, Gastrointestinal and Hepatobiliary Surgery – A propensity Matched Analysis

10.20944/preprints202009.0356.v1 ◽

2020 ◽

Author(s):

Bhavin Vasavada ◽

Hardik Patel

Keyword(s):

Surgical Site Infection ◽

Hospital Stay ◽

Malignant Disease ◽

Surgical Site Infections ◽

Site Infection ◽

Prolonged Hospital Stay ◽

Hepatobiliary Surgery ◽

Small Intestinal ◽

Prolonged Hospital ◽

Upper Gastrointestinal

Aims: Primary AIM of the study was to evaluate effect of prolonged hospital stay on Surgical site infections We also evaluated effect of prolonged hospital stay on overall morbidity in Gastrointestinal and Hepatobiliary Surgery as secondary outcome. Methods: We retrospectively analysed all the patients who underwent gastrointestinal and hepatobiliary surgery between April 2017 to March 2020. On our analysis we found mean hospital stay in patient who did not develop SSI and/or morbidity was 4 days (Total hospital stay) vs 6 days who developed morbidity (hospital stay before diagnosis of SSI or diagnosis or morbid event). Based on this to avoid selection bias, we did 1:1 propensity score analysis between patients who had 4 or less than hospital stay vs patients who had 5 or more hospital stay before diagnosis of surgical site infection and/or morbid event. We took all the preoperative and intraoperative factors like Age, sex, malignant disease, ASA score, CDC grade of surgery, open or laparoscopic surgery, HPB surgeries, colorectal surgeries, Upper Gastrointestinal surgeries and small intestinal surgeries as covariates. We used nearest neighbor matching protocol with a calipher of 0.2. Cases were not reusable after matching. Statistical analysis was done using SPSS version 23. Results: We included 348 patients operated between April 2017 and March 2020 in our analysis. After 1:1 propensity score matching 58 patients included in study arm (prevent hospital stay more than 4 days) and 56 patients in control arm. Both groups were comparable with regard to Age, Sex, Surgery for malignant disease, ASA score, CDC grade of surgery, HPB surgeries, Small intestinal surgeries, Colorectal surgeries, upper gastrointestinal surgeries, intraoperative blood product requirement, intraoperative hypotension or any other event, operative time. Prolonged hospital stay (> 4 days) was significantly associated with surgical site infections (p<0.0001), morbidity (p=0.001). Open surgeries were associated with prolonged hospital stay. (p=0.032). Conclusion: Prolonged Hospital stay is associated with increase surgical site infection and morbidity in Gastrointestinal and Hepatobiliary Surgery.

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Surgical site Infection after gastrointestinal and hepatobiliary surgeries- A retrospective evaluation from a single center of western India

Journal of Society of Surgeons of Nepal ◽

10.3126/jssn.v23i2.35802 ◽

2020 ◽

Vol 23 (2) ◽

pp. 31-35

Author(s):

Bhavin Vasavada ◽

Hardik Patel

Keyword(s):

Multivariate Analysis ◽

Surgical Site Infection ◽

Hospital Stay ◽

Univariate Analysis ◽

Surgical Site Infections ◽

Western India ◽

Site Infection ◽

Prolonged Hospital Stay ◽

Hepatobiliary Surgery ◽

Prolonged Hospital

Introduction: Aim of our study to evaluate various factors responsible for surgical site infection after gastrointestinal and hepatobiliary surgeries. Methods: Patients who underwent gastrointestinal and hepatobiliary surgery in our department were evaluated retrospectively. Various factors associated with surgical site infection were evaluated using univariate and multivariate analysis. Surgical site infection was defined as any culture positive discharge from the wound within 30 days of surgery. Results: We evaluated a total of 331 patients operated between April 2018 and March 2020. 14 patients were lost to follow up after discharge and before completing post operative day 30. Eighteen patients expired before 30 days without developing SSI and were excluded from the study as per exclusion criteria. 299 patients were included in the study. Twenty patients developed surgical site infection. It showed SSI rate in our study population was 6.68%. On univariate analysis prolonged hospital stay, more blood product used, higher CDC grade of surgery, higher ASA grade, more operative time, open surgeries, colorectal and HPB surgeries were associated with surgical site infections. On multivariate analysis only prolonged hospital stay independently predicted SSI. (p=0.014, Odds ratio 1.223, 95% confidence interval 1.042-1.435.). Conclusion: Prolonged hospital stay independently predicts surgical site infections after gastrointestinal and hepatobiliary surgery.

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A study on the design of a wardrobe, for patients bed-ridden with cancer, applying the knowledge of anonymous design

Impact ◽

10.21820/23987073.2020.7.45 ◽

2020 ◽

Vol 2020 (7) ◽

pp. 45-47

Author(s):

Naoko Fujii

Keyword(s):

Hospital Stay ◽

Nursing Care ◽

Healthcare Professionals ◽

The Other ◽

Human Beings ◽

Prolonged Hospital Stay ◽

Hospital Patients ◽

Hospital Gowns ◽

Hospital Stays ◽

Prolonged Hospital

The majority of human beings will be admitted to hospital at some point over the course of their lives. For the more fortunate among us, these hospital stays will be brief and will barely register as a significant experience. However, for others, being admitted for weeks or months at a time will be necessary in order to combat and recover from whatever it was that made admittance to hospital necessary. While it is easy to think of many reasons why a prolonged hospital stay might be undesirable, one that may escape our attention is the clothes that are worn by patients during their stay. Once a patient has been assigned a bed, they are often given a gown which they put on without thought and then lie down. The gowns that are given to patients are generally designed with healthcare professionals in mind. For example, in Japan pyjamas and yukata (bathrobes) are used as hospital gowns because they have a front opening that is easy to use during treatment and nursing care. In addition, the other gowns can be opened from the ankle to the crotch using the zip. Dr Naoko Fujii has focused her career on designing clothes for hospital patients and believes that there is a way to satisfy the practical needs of a hospital and the care it gives at the same time as satisfying the requirements of patients. She is now focusing her attention on this challenge.

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