scholarly journals Incidence of surgical site infections in a urology department

2011 ◽  
Vol 58 (1) ◽  
pp. 61-65 ◽  
Author(s):  
Ljiljana Markovic-Denic ◽  
Violeta Rakic ◽  
Milovan Maksimovic ◽  
Milan Djokic
Keyword(s):  
Cohort Study ◽  
Incidence Rate ◽  
Preventive Measures ◽  
Surgical Site Infections ◽  
Incidence Rates ◽  
Hospital Infections ◽  
Asa Score ◽  
One Year ◽  
Definition Of ◽  
Clean Contaminated

Objectives: To determine the incidence of surgical site infections (SSI) in the urology wards as well as the SSI incidence in relation to the ASA score and surgical site contamination class. Materials and methods: One-year prospective cohort study was conducted in the Urologic department, General hospital, Sabac. The patients were daily examined and their diagnoses were made according to the definition of hospital infections using concurrently the ASA score and surgical site contamination class. Results: Out of 241 operated patients, 32 patients were diagnosed with 33 SSI. The overall incidence rate of patients with SSI was 5.9% while incidence rate of SSI was 6.1%. There were not the differences in the incidence rates according to the ASA score of patients (p>0.05). The incidence of SSI was 5.0% in the clan wounds, 11.2% in the clean-contaminated, and 20.7% in the contaminated wounds (?2=8.2 DF=2 p<0.016). The patients with SSIs were hospitalized approximately 2 times longer than the patients without SSI (t=-6,28; df=239; p<0,001). Conclusion: This study suggests that it is necessary to maintain continous surveillance of surgical site infections and to implement the preventive measures, especially for clean and clean-contaminated surgery.

scholarly journals Incidence of surgical site infections in the departments of orthopedics and traumatology

2006 ◽  
Vol 63 (8) ◽  
pp. 725-729 ◽  
Author(s):  
Jadranka Maksimovic ◽  
Ljiljana Markovic-Denic ◽  
Marko Bumbasirevic ◽  
Jelena Marinkovic
Keyword(s):  
Surgical Site Infections ◽  
Good Health ◽  
Health Condition ◽  
Surgical Patients ◽  
Epidemiological Surveillance ◽  
Hospital Infections ◽  
Asa Score ◽  
Clinical Center ◽  
Definition Of ◽  
Good Health Condition

Background/aim: Besides infections of urinary tract and pneumonias, as well as blood infections, surgical site infections (SSI) represent one of the most common localization of hospital infections. The aim of this study was to determine the incidence of SSI in the departments of orthopedics and traumatology as well as the SSI incidence in relation to the ASA score, surgical site contamination class and NNIS index. Methods. A prospective cohort study followed daily all the surgical patients hospitalized over 48 hours in the Institute for Orthopedic Surgery and Traumatology, Clinical Center of Serbia, as well as 30 days after the discharge, during the period between February 1 to July 31, 2002. The patients were examined and their diagnoses made according to the definition of hospital infections, i.e. upon clinical and/or laboratory analyses, using concurrently the ASA score, surgical site contamination class and NNIS index. Results. Out of 227 surgical patients, 60 were diagnosed with SSI during their hospitalization, while 3 of the patients developed SSI after the discharge. The incidence of SSI was 22.7% (95% CI = 17.8?27.6). In the patients with good health condition, i.e. ASA ? 2, the incidence of SSI was 18.3% (43/235) and in those with ASA > 2, it was 47.6% (20/42) (?2 = 17.4; p < 0.001). The incidence of SSI was 13.5% (25/185) in the clean wounds, 11.6% (5/43) in purely contaminated, while it was much higher in the contaminated 65.5%; (19/29) and soiled 70.0%; (14/20) wounds (?2 = 67.6; p < 0.001). The incidence of SSI in relation to NNIS was 8.1% (13/161) in the patients with score 0, then 36.4% (32/88) in the patients with score 1, and 64.3% (18/28) in the patients with the scores 2 and 3 (?2 = 57.3; p < 0.001). The patients with SSI stayed in the departments of orthopedics and traumatology approximately 1.8 times longer than the patients without SSI (t = 5.3; DF = 275; p < 0.0019. Conclusion. It is important to emphasize the need for constant epidemiological surveillance of SSI and the implementation of preventive measures in Serbia.

scholarly journals Incidencija infekcija operativnog mesta posle operacija na otvorenom srcu

2010 ◽  
Vol 57 (2) ◽  
pp. 45-48
Author(s):  
Lj. Markovic-Denic ◽  
B. Mihajlovic ◽  
N. Cemerlic-Adjic ◽  
S. Nicin ◽  
K. Pavlovic ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Surgical Techniques ◽  
Surgical Site Infections ◽  
Medical Problem ◽  
Incidence Rates ◽  
Hospital Infections ◽  
Antimicrobial Drugs ◽  
Microbiological Methods

Introduction: Despite modern surgical techniques, preoperative preventive use of antibiotics and optimal treatment of operative site, surgical site infections (SSI) are significant medical problem in the countries worldwide. Objective: The aim of this paper was to estimate the frequency of SSI after open heart surgery and to identify the most frequent causes of these infections. Material and methods: A prospective cohort study was performed during the period from January 2008 to December 2009 at the Clinic of Cardiovascular Surgery of the Institute of Cardiovascular Diseases, Vojvodina. The surveillance was consistent throughout the study period. During hospitalization, patients were evaluated daily by the infection control nurse. Isolation, identification and sensitivity tests of causative agents to antimicrobial drugs, obtained from patients' material, were carried out by standard microbiological methods. The descriptive epidemiological method was used. The incidence rates of hospital infections were calculated. Results: During the study period, among 23 patients, 24 SSIs were registered. The average incidence rate of patients with SSI was 0.98% and SSI rate was 1.02% (ranged from 0% to 3.7%). There was no difference in the incidence rates according to gender (p=0.65).The mean age of patients with SSI was 64.7 years. Except one, all patients had the ASA score higher than 2. The patients with SSIs were hospitalized approximately 3.8 times longer than the patient without SSI (p=0.03). The most common causes of SSI were: Staphylococcus aureus (30%), coagulasa-negative Staphylococcus spp, Acinetobacter spp (8%), Enterococcus spp and Klebsiella pneumoniae. Conclusion: Although the incidence rate of hospital infections is low, it is necessary to maintain continuous surveillance of surgical site infections and to implement the preventive measures.

scholarly journals Geographical variation and clustering are found in atrial fibrillation beyond socioeconomic differences: a Danish cohort study, 1987–2015

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Kirstine Wodschow ◽  
Kristine Bihrmann ◽  
Mogens Lytken Larsen ◽  
Gunnar Gislason ◽  
Annette Kjær Ersbøll
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Cohort Study ◽  
Incidence Rate ◽  
Socioeconomic Position ◽  
Geographical Variation ◽  
Incidence Rates ◽  
Socioeconomic Differences ◽  
Individual Level ◽  
Geographical Variations

Abstract Background The prevalence and incidence rate of atrial fibrillation (AF) increase worldwide and AF is a risk factor for more adverse cardiovascular diseases including stroke. Approximately 44% of AF cases cannot be explained by common individual risk factors and risk might therefore also be related to the environment. By studying geographical variation and clustering in risk of incident AF adjusted for socioeconomic position at an individual level, potential neighbourhood risk factors could be revealed. Methods Initially, yearly AF incidence rates 1987–2015 were estimated overall and stratified by income in a register-based cohort study. To examine geographical variation and clustering in AF, we used both spatial scan statistics and a hierarchical Bayesian Poisson regression analysis of AF incidence rates with random effect of municipalities (n = 98) in Denmark in 2011–2015. Results The 1987–2015 cohort included 5,453,639 individuals whereof 369,800 were diagnosed with an incident AF. AF incidence rate increased from 174 to 576 per 100,000 person-years from 1987 to 2015. Inequality in AF incidence rate ratio between highest and lowest income groups increased from 23% in 1987 to 38% in 2015. We found clustering and geographical variation in AF incidence rates, with incidence rates at municipality level being up to 34% higher than the country mean after adjusting for socioeconomic position. Conclusions Geographical variations and clustering in AF incidence rates exist. Compared to previous studies from Alberta, Canada and the United States, we show that geographical variations exist in a country with free access to healthcare and even when accounting for socioeconomic differences at an individual level. An increasing social inequality in AF was seen from 1987 to 2015. Therefore, when planning prevention strategies, attention to individuals with low income should be given. Further studies focusing on identification of neighbourhood risk factors for AF are needed.

scholarly journals Incidence study of surgical site infections in a large University Hospital in Rome, first results

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
D Vallone ◽  
M Di Pumpo ◽  
A Gentili ◽  
A Tamburrano ◽  
F Berloco ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Incidence Rate ◽  
Health Management ◽  
Surgical Site Infections ◽  
University Hospital ◽  
Surveillance Systems ◽  
Hospital Infections ◽  
Post Discharge ◽  
Average Hospital ◽  
Hospital Units

Abstract Background Surgical Site Infections (SSI) represent about a quarter of healthcare associated infections (HAI), increase the risk of mortality and hospital stay and extend healthcare costs. The aim of this work is to evaluate the incidence of SSI in patients undergoing surgical procedures of Hospital Units in the Fondazione Policlinico A. Gemelli IRCCS (FPG). Methods This descriptive observational monocentric study has a 30-months duration: the first phase was conducted between July 2018 and March 2019. Patients undergoing abdominal surgery procedures were enrolled. Active infection surveillance was performed, according to the ECDC, during the hospital stay and the surgical outpatient visits. We also performed a post-discharge surveillance (PDS) at 30 days (or 90 days if an implant has been inserted), through a telephone interview, made by a medical doctor resident in Public Health. Results During the first phase were enrolled 431 procedures in 2 Hospital Units, about emergency and hepatobiliary surgery. There were 53 cases of surgical site infection (SSI) highlighted in these procedures. Therefore, SSI’s were reported in 12.09% of the procedures. In particular, in 6.28% of cases, SSIs were diagnosed during the hospital stay. The results of this study showed statistically significant differences (p &lt; 0.005) in incidence rate of emergency (10,70%) and hepatobiliary tract (13,17%) procedures. The average hospital stay was significant higher (p &lt; 0.001) in patients who developed an SSI (17.27 days) than in patients without SSI (4.89 days). Conclusions These preliminary results show that the incidence rate of SSI for gastrointestinal procedures is similar to other European Countries (9.6%). The Hospital Health Management of FPG take care to the surveillance of hospital infections and monitor the correct application of the procedures, in line with the standards defined by Joint Commission International for guarantee high level in patients’ care. Key messages Performing a survey to measure the incidence of surgical site infections for surgery procedures is very important to define it and to improve surveillance systems of hospital infections in FPG. Active surveillance of surgical site infections may allow to enhance appropriate preventive measures.

Decreased Incidence of Osteonecrosis of the Jaw (ONJ) in Patients with Multiple Myeloma (MM) Treated with Zoledronic Acid (ZA) after Application of Preventive Measures.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 3609-3609 ◽  
Author(s):  
Meletios Athanasios Dimopoulos ◽  
Efstathios Kastritis ◽  
Christina Bamia ◽  
Ioannis Melakopoulos ◽  
Dimitra Gika ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Preventive Measures ◽  
Score Test ◽  
Osteonecrosis Of The Jaw ◽  
Incidence Rates ◽  
Exact Test ◽  
Analysis Group ◽  
Dental Procedures ◽  
Group A ◽  
Group B

Abstract Background. Bisphosphonates are widely used in the treatment of MM. ONJ can occur during treatment with bisphosphonates. We have shown that use of ZA and longer exposure are associated with higher frequency of ONJ in a series of patients with both MM and solid tumors. Dental problems or interventions are precipitating factors of ONJ. For this reason, since 2003, we have implemented assessment (and management if necessary) of all patients who are candidates for ZA or who are on treatment with ZA and have dental problems by specialists with particular experience on ONJ. In addition, we recommend improved oral hygiene and we avoid dental procedures during treatment with ZA. We have investigated whether the occurrence of ONJ decreased after the implementation of these measures. Patients and Methods. According to the policy of our center, all patients with MM who demonstrate lytic lesions or osteopenia receive ZA 4 mg i.v. every 4 weeks indefinitely. In our current analysis we included patients who received only ZA wheras patients who initially received pamidronate and were later switched to ZA were excluded. Patients were stratified into two groups depending on the date of initiation of treatment in relation to the start of implementation of the preventive measures (Group A: 26/8/1998–31/12/2002, Group B: 1/1/2003–1/12/2006). Occurrence of ONJ was studied as row percentages as well as incidence rate rates (IR: number of cases of osteonecrosis /person-months). The proportions of patients with ONJ between the two groups were compared with the Fisher’s exact test whereas the respective incidence rates were compared with the score test. The 95% confidence interval of the incidence rate ratio was also estimated. Results. One hundred twenty-eight patients with MM were included in the analysis (Group A: 35, Group B: 93; M/F: 66/62). Overall there were 10 cases of ONJ (8%): 8 cases in Group A (23%) and 2 cases in Group B (2%) (p&lt;0.001). The IR was 0.560/100 person-month for Group A and 0.118/100 person-month for Group B. The IRR was Group A/Group B: 4.76 (p=0.029, 95% CI: 1.01–22.40). Median time of exposure among patients with ONJ was 31 months for Group A and 8 months for Group B (p=0.044). Conclusions. The implementation of detailed assessment by experienced specialists of patients with MM and dental problems and the avoidance of dental procedures during treatment with ZA results in a significant 5-fold reduction of ONJ. Our data provide a basis for a safer use of ZA in MM.

scholarly journals Incidence of Lyme disease in the United Kingdom and association with fatigue: a population-based, historical cohort study

2021 ◽  
Author(s):  
Florence Brellier ◽  
Mar Pujades-Rodriguez ◽  
Emma Powell ◽  
Kathleen Mudie ◽  
Eliana Mattos Lacerda ◽  
...  
Keyword(s):  
Cohort Study ◽  
Lyme Disease ◽  
Incidence Rate ◽  
Chronic Fatigue ◽  
Disease Diagnosis ◽  
Population Based ◽  
Incidence Rates ◽  
Historical Cohort ◽  
Historical Cohort Study ◽  
The Uk

Objectives To evaluate incidence rates of Lyme disease in the UK and to investigate a possible association with subsequent fatigue Design Population-based historical cohort study with a comparator cohort matched by age, sex, and general practice Setting Patients treated in UK general practices contributing to IQVIA Medical Research Data Participants 2,130 patients with a first diagnosis of Lyme disease between 2000 and 2018, and 8,510 randomly-sampled matched comparators, followed-up for a median time of 3 years and 8 months. Main outcome measures Time from Lyme disease diagnosis to consultation for any fatigue-related symptoms or diagnosis and for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Adjusted hazard ratios (HRs) were estimated from Cox models. Results Average incidence rate for Lyme disease across the UK was 5.18 per 100,000 py between 2000 and 2018, increasing from 2.55 in 2000 to 9.33 in 2018. In total 929 events of any types of fatigue were observed, i.e. an incidence rate of 307.90 per 10,000 py in the Lyme cohort (282 events) and 165.60 in the comparator cohort (647 events). Effect of Lyme disease on any subsequent fatigue varied by index season with highest adjusted HRs in autumn [3.14 (95%CI: 1.92 to 5.13)] and winter [2.23 (1.21 to 4.11)]. Incidence rates of ME/CFS were 11.16 per 10,000 py in Lyme patients (12 events) and 1.20 in comparators (5 events), corresponding to an adjusted HR of 16.95 (5.17 to 55.60). Effect on any types of fatigue and ME/CFS was attenuated 6 months after diagnosis but still clearly visible. Conclusions UK primary care records provided strong evidence that Lyme disease was associated with acute and chronic fatigue. Albeit weaker, these effects persisted beyond 6 months, suggesting that patients and healthcare providers should remain alert to fatigue symptoms months to years following Lyme disease diagnosis.

Trends in Incidence and Survival of Myeloid Malignancies Since 1980, in the Côte D'or Department, Burgundy, France.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 3122-3122
Author(s):  
Marc Maynadié ◽  
Ines Manivet ◽  
Morgane Mounier ◽  
Francine Mugneret ◽  
François Bailly ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Conflicts Of Interest ◽  
Myeloproliferative Neoplasms ◽  
Relative Survival ◽  
Incidence Rates ◽  
Good Survival ◽  
World Population ◽  
Myeloid Malignancies ◽  
Urban Rural ◽  
Definition Of

Abstract Abstract 3122 Poster Board III-59 Objective The Registry of Haematological Malignancies (HM) has been established on January 1st, 1980 in the department of Côte d'Or (pop 500 000 inhabitants). It was the first specialized registry in haematology in the world. During the course of 25 years (1980-2004), 5026 cases of HM were recorded including 1553 Myeloid malignancies (MM) in which entities not initially considered as malignant were taken in account such as Myelodysplastic syndrome (MDS) and some Myeloproliferative neoplasms (MPN). This allow us to present trends in incidence and survival of myeloid malignancies by entities since 1980. Method MM diagnosed in the population between 01/01/1980 and 31/12/2004 were registered. They were coded according to ICD-O-3 and following the principles of the 2001 WHO classification i.e. new threshold of definition of acute myeloid leukaemia (AML). World population standardized incidence rate were calculated by sex, age, by urban /rural repartition and by period of time. Five-year, 10-y, 15-y and 20-y relative survival was calculated using Estève's method and based on vital status updated at the end of 2007. Results Incidence rate for whole MM were 3.73/100 000/y in men and 2.74 in women. They were 2.82 for AML, 3.73 in MPN and 2.83 in MDS. Sex ratio was 1.5/1 as a whole and urban/ratio was always close to 2, data being statistically significant for numerous entities. Incidence rates increase with age until 75y-o for AML and 80y-o for MPN and then decreased except for MDS in which incidence continue to increase. Along the period, only incidence of MDS increases significantly with an annual medium rate of 3% (2.7 in men and 3.3 in women). In MPN, a significant increase was observed only for women (2%). Within AML, surprisingly a significant increase was found for AML with recurrent cytogenetic abnormality in men (8.03%). 15-years relative survival was the best for MPN (46%), being significantly better in women (59% vs 31%), in which Essential Thrombocythemia was the best (74%). On the contrary, the worst 15-y survival was for was for MDS (9%). Within AML, the best survival was found for AML recurrent cytogenetic abnormalities (15-y: 54%) compare to other categories (4-8%). Survival has not increased along the period, has increased significantly in MPN. In AML, 10-y survival has increased until 1999 to reach 39% but has decreased for the 2000-2004 period (8-y: 11%). Conclusion Analysis of the largest epidemiologic database on HM allow to produce information such as a significant increase of incidence of MDS in which survival remained very poor in both sex, a good survival of MPN compared to other categories and a worrying decreased of survival of AML in the more recent period. Disclosures No relevant conflicts of interest to declare.

scholarly journals Incidence of rectosigmoid adenomatous polyps in subjects without prior colorectal adenoma or cancer: a prospective cohort study

Gut ◽  
1999 ◽  
Vol 44 (3) ◽  
pp. 372-376 ◽  
Author(s):  
B Paillot ◽  
P Czernichow ◽  
P Michel ◽  
V Merle ◽  
A-M Queuniet ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cohort Study ◽  
Incidence Rate ◽  
Selection Criteria ◽  
Incidence Rates ◽  
Colorectal Adenomas ◽  
Population Characteristics ◽  
The Third ◽  
Mean Delay ◽  
Screening Strategies

BACKGROUNDSubjects without known colorectal adenomas or cancer constitute a large majority of the population where 85% of all cases of colorectal cancer are thought to occur. Consequently these people should be considered for screening to decrease mortality from colorectal cancer in the general population.AIMSTo estimate the incidence rate of rectosigmoid adenomas in these subjects.METHODSSubjects without adenomas or cancer at a previous examination which had visualised the rectosigmoid underwent a fibre endoscopy every three years. Endoscopic data and population characteristics were collected prospectively.RESULTSA total of 450 subjects fulfilled the selection criteria; 287 (64%) underwent at least two examinations, and 163 had three or more. At the second examination, with a mean delay of 39 months, the incidence rate of rectosigmoïd adenomas was 1.50% per patient year. The rate was 1.75% per patient year (95% CI 0.80–3.33) at the third endoscopy with an additional mean delay of 38 months. The cumulative incidence rate at six years was 7.3% (95% CI 4.3–10.3), representing a mean of 1.2% per patient year. This rate increased with age and was higher for men than for women after age adjustment (p< 0.03).CONCLUSIONSThe incidence rates are very low compared with those of patients with prior adenomas. These results should be considered in establishing rectosigmoid adenoma screening strategies.

Pediatric surgical site infection (SSI) following ambulatory surgery: Incidence, risk factors and patient outcomes

2021 ◽  
pp. 1-7
Author(s):  
Michael L. Rinke ◽  
David G. Bundy ◽  
Moonseong Heo ◽  
Lisa Saiman ◽  
Barbara Rabin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ambulatory Surgery ◽  
Operative Procedure ◽  
Epidemiologic Study ◽  
Surgical Site Infections ◽  
Incidence Rates ◽  
Medical Centers ◽  
Incidence Risk ◽  
Contaminated Wound ◽  
Clean Contaminated

Abstract Background: Inpatient surgical site infections (SSIs) cause morbidity in children. The SSI rate among pediatric ambulatory surgery patients is less clear. To fill this gap, we conducted a multiple-institution, retrospective epidemiologic study to identify incidence, risk factors, and outcomes. Methods: We identified patients aged <22 years with ambulatory visits between October 2010 and September 2015 via electronic queries at 3 medical centers. We performed sample chart reviews to confirm ambulatory surgery and adjudicate SSIs. Weighted Poisson incidence rates were calculated. Separately, we used case–control methodology using multivariate backward logistical regression to assess risk-factor association with SSI. Results: In total, 65,056 patients were identified by queries, and we performed complete chart reviews for 13,795 patients; we identified 45 SSIs following ambulatory surgery. The weighted SSI incidence following pediatric ambulatory surgery was 2.00 SSI per 1,000 ambulatory surgeries (95% confidence interval [CI], 1.37–3.00). Integumentary surgeries had the highest weighted SSI incidence, 3.24 per 1,000 ambulatory surgeries (95% CI, 0.32–12). The following variables carried significantly increased odds of infection: clean contaminated or contaminated wound class compared to clean (odds ratio [OR], 9.8; 95% CI, 2.0–48), other insurance type compared to private (OR, 4.0; 95% CI, 1.6–9.8), and surgery on weekend day compared to weekday (OR, 30; 95% CI, 2.9–315). Of the 45 instances of SSI following pediatric ambulatory surgery, 40% of patients were admitted to the hospital and 36% required a new operative procedure or bedside incision and drainage. Conclusions: Our findings suggest that morbidity is associated with SSI following ambulatory surgery in children, and we also identified possible targets for intervention.

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