P-O08 Effect of socioeconomic deprivation on clinical characteristics and outcomes of patients undergoing an emergency appendectomy

Abstract Background Appendicectomy is one of the commonest emergency general surgical operations performed. Previous studies have shown that socioeconomic status (SES) impact outcomes in a number of diseases. Currently, there is no study analysing the impact of SES on the outcome of appendectomy. Our aim was to compare the clinical characteristics and outcomes of adults having an emergency appendectomy between deprived and less deprived SES groups. Methods A multicentre retrospective observational study of all adult patients who had an emergency appendectomy across four hospitals (two district general and two tertiary care hospitals) between August 2018 and November 2020 was performed. Patients were identified through pathology records. Data was extracted from electronic records for demographics, pre-operative (peak) blood results, pre and post-operative imaging, operative details and the clinical outcomes. Patient’s residential address was used to calculate Scottish Index of Multiple Deprivation (SIMD). The patients were grouped by SIMD into a more deprived SES group (SIMD 1-5) and a less deprived SES group (SIMD 6-10) and results compared. Results A total of 1,105 patients (57.5% male) were included. Median age was lower in the more deprived group (35 vs 40 years, p < 0.001). The less deprived group were more likely to be fitter: ASA-1 grade 51.6% vs 43.5%, p = 0.008. There were fewer appendectomies in most deprived decile compared to the least deprived decile (5.2 vs 11.3 per 10,000 population per year, p < 0.001). There was no difference in inflammatory markers, pre-operative imaging, surgical approach, severity of appendicitis and the median length of stay (3 days). However, there were more surgical site infection in the more deprived group (3.4% vs 0.9%, p = 0.006). Conclusions This study demonstrates that SES does impact on the age of presentation and incidence of appendectomy. Surgical site infection were seen more frequently in the more deprived patients undergoing emergency appendectomy. This may be a reflection of the underlying comorbidities.

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SURGICAL SITE INFECTION RELATED RISK FACTORS AND USAGE OF ANTIBIOTICS IN TWO DIFFERENT TERTIARY CARE HOSPITALS OF DHAKA CITY, BANGLADESH

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2018.v11i8.25878 ◽

2018 ◽

Vol 11 (8) ◽

pp. 184

Author(s):

Forhad Monjur ◽

Farhana Rizwan ◽

Nobo Krishna Ghosh

Keyword(s):

Risk Factors ◽

Surgical Site Infection ◽

Tertiary Care ◽

Surgical Patients ◽

Main Concern ◽

Dhaka City ◽

Site Infection ◽

Drug Of Choice ◽

Duration Of Surgery ◽

Tertiary Care Hospitals

Objective: Surgical site infection (SSI) is the most common complications following surgical procedures. The aim of the study was to assess the risk factors for SSI and the antibiotic treatment pattern following post-operative infection.Methods: This retrospective study has been considered the data of 156 surgical patients from two tertiary care hospitals in Dhaka city of Bangladesh.Result: The majority (31.4%) of the surgical patients came from the age group 40 to 49 years. A total of 8 SSI cases were discovered, 5 cases (8.9%) from Hospital-1, which was relatively higher (3%) than Hospital-2. Wound class “contaminated” was found in 6 cases, and the ratio is almost 1:3 or 75%. The duration of surgery within 90–120 min for 50% of SSI patients (4/8). Most frequent types of surgery were colorectal surgery (56.4%, 88/156), followed by various grades of fistula (24.4%, 38/156). The prophylaxis antibiotic was ceftriaxone, used by 77 (49.4%) cases. Commonly used antibiotic was ciprofloxacin, administered in 33 (21.2%) patients as a single therapy. Third-generation cephalosporins (cefixime, ceftriaxone, and cefuroxime) were found at the drug of choice in combination with gentamicin/metronidazole/nitazoxanide or amikacin.Conclusion: This study tried to give a little overview of SSI in different hospital settings, whereas improvement of preventive measures, early detection, and management of SSI is the main concern of nowadays. Further research should be done to get the detail by considering all the relevant factors of SSI.

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Bacteriological Profile of Surgical Site Infection From A Tertiary Care Hospital, From Western India

Indian Journal Of Applied Research ◽

10.15373/2249555x/jan2014/120 ◽

2011 ◽

Vol 4 (1) ◽

pp. 397-400

Author(s):

Dr.Arti Jain ◽

◽

Dr. Sunita Bhatawadekar ◽

Dr. Meera Modak

Keyword(s):

Surgical Site Infection ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Western India ◽

Care Hospital ◽

Site Infection ◽

Bacteriological Profile

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The impact of COVID-19 related national lockdown on ophthalmic emergency in Italy: A multicenter study

European Journal of Ophthalmology ◽

10.1177/11206721211028046 ◽

2021 ◽

pp. 112067212110280

Author(s):

Maria L Salvetat ◽

Carlo Salati ◽

Patrizia Busatto ◽

Marco Zeppieri

Keyword(s):

Gender Bias ◽

Tertiary Care ◽

Lower Number ◽

Electronic Records ◽

Chi Square ◽

Efficient Access ◽

Chi Square Test ◽

Unpaired Student ◽

The Impact ◽

Wet Amd

Purpose: To assess ocular pathologies admitted to Italian Emergency Eye Departments (EEDs) during the COVID-19 pandemic national lockdown in 2020 in comparison with the same period in 2019. Methods: Electronic records of all patients presenting at EEDs of two tertiary-care Eye Centers during the COVID-19 national lockdown in Italy (March 10–May 3, 2020) were compared with the equivalent period in 2019. Main outcomes were patient age, gender, and diagnoses. Statistical analysis included unpaired Student t-tests, Poisson regression, and chi-square test. Results: Overall EED visits significantly decreased by 54.1% during the 2020 lockdown compared to 2019 (851 vs 1854, p < 0.001). During lockdown, patients showed comparable mean age (52.8 years in 2020 vs 53.3 years in 2019, p = 0.52) and significant male gender bias (61.1% in 2020 vs 55.8% in 2019, p < 0.0001). The most frequent pathologies were eye inflammations, trauma-related incidents, and spontaneous acute vitreous detachment. Patients with inflammation, headache/hemicrania, and spontaneous subconjunctival hemorrhages were significantly less, whereas those with trauma-related diagnoses were significantly higher during the lockdown as compared with 2019 ( p < 0.05). The proportion of non-urgent visits decreased from 17% in 2019 to 8% in 2020 ( p < 0.001). Conclusions: During the 2020 lockdown, there was a significant reduction of accesses to EED, especially for non-urgent pathologies. Potentially visual function threatening conditions, such as trauma-related pathologies, retinal detachment or ruptures, and wet AMD, showed lower number of cases but higher or stable proportion relative to the total caseload, suggesting a correct and efficient access to ophthalmic health care during the pandemic period.

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58 Use of Abdominal Wall or Sucutaneous Drain to Reduce the Risk of Surgical Site Infections

British Journal of Surgery ◽

10.1093/bjs/znab134.356 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

H Mistry ◽

B Woolner ◽

A John

Keyword(s):

Surgical Site Infection ◽

Open Cholecystectomy ◽

Surgical Site Infections ◽

Standard Operating Procedure ◽

Site Infection ◽

Infection Rates ◽

Local Evidence ◽

Audit Data ◽

The Impact ◽

To Receive

Abstract Introduction Open abdominal surgery confers potentially greater risk of surgical site infections, and local evidence suggests use of drains can reduce this. Our objectives were: Assessing local rates and risk factors of infections and if use of drains can reduce the rates of infections. Method Retrospectively looking from 01/01/2018 to 31/12/2018, at patients following laparotomy or open cholecystectomy. Data collection on demographics, smoking/alcohol status, heart, respiratory or renal disease or diabetes, steroid use and CEPOD status, as well as use of drain and the outcome of infection using inpatient and online patient records. Results 84 patients included, 25 had drains inserted. There were 13 documented cases of surgical site infection, all of whom had no drain post-op. Other parameters shown to be most prevalent in the patients with a surgical site infection include being current/ex-smoker (8/13), having heart disease (9/13), and elective procedures. Conclusions Aiming to reduce the risk of surgical site infections can improve morbidity and potentially mortality outcomes. Our audit data showed that there appears to be a benefit of inserting intra-abdominal or subcutaneous drains. We will create a standard operating procedure of all patient to receive drains post-op and then re-audit to assess the impact this has on infection rates.

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Surgical Site Infection Following Caesarean Section by Acinetobacter Species: A Report from a Hyperendemic Setting in the Brazilian Amazon Region

Microorganisms ◽

10.3390/microorganisms9040743 ◽

2021 ◽

Vol 9 (4) ◽

pp. 743

Author(s):

Blenda Gonçalves Cabral ◽

Danielle Murici Brasiliense ◽

Ismari Perini Furlaneto ◽

Yan Corrêa Rodrigues ◽

Karla Valéria Batista Lima

Keyword(s):

Caesarean Section ◽

Surgical Site Infection ◽

Carbapenem Resistance ◽

Brazilian Amazon ◽

Amazon Region ◽

Site Infection ◽

Acinetobacter Species ◽

Brazilian Amazon Region ◽

Acinetobacter Spp ◽

The Impact

Surgical site infection (SSI) following caesarean section is associated with increased morbidity, mortality, and significant health care costs. This study evaluated the epidemiological, clinical, and microbiological features of Acinetobacter spp. in women with SSIs who have undergone caesarean section at a referral hospital in the Brazilian Amazon region. This study included 69 women with post-caesarean SSI by Acinetobacter spp. admitted to the hospital between January 2012 and May 2015. The 69 Acinetobacter isolates were subjected to molecular species identification, antimicrobial susceptibility testing, detection of carbapenemase-encoding genes, and genotyping. The main complications of post-caesarean SSI by Acinetobacter were inadequate and prolonged antibiotic therapy, sepsis, prolonged hospitalization, and re-suture procedures. A. baumannii, A. nosocomialis and A. colistiniresistens species were identified among the isolates. Carbapenem resistance was associated with OXA-23-producing A. baumannii isolates and IMP-1-producing A. nosocomialis isolate. Patients with multidrug-resistant A. baumannii infection showed worse clinical courses. Dissemination of persistent epidemic clones was observed, and the main clonal complexes (CC) for A. baumannii were CC231 and CC236 (Oxford scheme) and CC1 and CC15 (Pasteur scheme). This is the first report of a long-term Acinetobacter spp. outbreak in women who underwent caesarean section at a Brazilian hospital. This study demonstrates the impact of multidrug resistance on the clinical course of post-caesarean infections.

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Impact of COVID-19 pandemic on non-COVID patient’s management in urology: a public hospital experience in Mumbai

African Journal of Urology ◽

10.1186/s12301-021-00196-0 ◽

2021 ◽

Vol 27 (1) ◽

Author(s):

Nikhilesh A. Jibhakate ◽

Sujata K. Patwardhan ◽

Ajit S. Sawant ◽

Hemant R. Pathak ◽

Bhushan P. Patil ◽

...

Keyword(s):

Tertiary Care ◽

Stone Disease ◽

Outpatient Clinics ◽

Percentage Decrease ◽

Emergency Procedures ◽

Number Of Patients ◽

Long Term Impact ◽

Tertiary Care Hospitals ◽

The Impact ◽

Near Future

Abstract Background To evaluate the impact of COVID-19 lockdown on non-COVID urological patient’s management in tertiary care urology centres. Methods This is an observational study in which data of patients visiting the urology department of all the MCGM run tertiary care hospitals were recorded for the duration of 1 April 2020 to 31 July 2020 and were compared to data of pre-COVID-19 period of similar duration. Results There was a decrease of 93.86% in indoor admissions of urology patients during the COVID-19 lockdown. Indoor admissions for stone disease, haematuria, malignancy accounted for 53.65%, 15.85%, 9.75%, respectively. Elective surgeries had the highest percentage decrease followed by emergency and semi-emergency procedures. There was a reduction of more than 80% in patients attending outpatient clinics. Stone disease and its consequences were the main reasons for visiting outdoor clinics (39%). A substantial number of patients presented with flank and abdominal pain (14.8%) and benign enlargement of the prostate (10.23%). Malignancy accounted for a very small number of patients visiting outdoor clinics (1.58%). Conclusions COVID-19 pandemic has a profound impact on patient care and education in Urology. There was more than ninety percent reduction in indoor admissions, operative procedures, and outpatient clinics attendance. Once the pandemic is controlled, there will be a large number of patients seeking consultation and management for urological conditions and we should be prepared for it. Surgical training of urology residents needs to be compensated in near future. Long-term impact on urological patient outcome remains to be defined.

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