Impact of surgical site infection on healthcare costs and patient outcomes: a systematic review in six European countries
TL;DR: It is indicated that SSIs are extremely costly and rigorous procedures must be implemented to minimize SSIs, and more economic and QoL studies are required to make accurate cost estimates and to understand the true burden of SSIs.
About: This article is published in Journal of Hospital Infection.The article was published on 2017-05-01 and is currently open access. It has received 495 citations till now. The article focuses on the topics: Quality of life.
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TL;DR: A 2018 retrospective analysis of Medicare beneficiaries identified that ∼8.2 million people had wounds with or without infections, with highest expenses were for surgical wounds followed by diabetic foot ulcers, with a higher trend toward costs associated with outpatient wound care compared with inpatient.
Abstract: Significance: A 2018 retrospective analysis of Medicare beneficiaries identified that ∼8.2 million people had wounds with or without infections. Medicare cost estimates for acute and chronic wound treatments ranged from $28.1 billion to $96.8 billion. Highest expenses were for surgical wounds followed by diabetic foot ulcers, with a higher trend toward costs associated with outpatient wound care compared with inpatient. Increasing costs of health care, an aging population, recognition of difficult-to-treat infection threats such as biofilms, and the continued threat of diabetes and obesity worldwide make chronic wounds a substantial clinical, social, and economic challenge. Recent Advances: Chronic wounds are not a problem in an otherwise healthy population. Underlying conditions ranging from malnutrition, to stress, to metabolic syndrome, predispose patients to chronic, nonhealing wounds. From an economic point of view, the annual wound care products market is expected to reach $15-22 billion by 2024. The National Institutes of Health's (NIH) Research Portfolio Online Reporting Tool (RePORT) now lists wounds as a category. Future Directions: A continued rise in the economic, clinical, and social impact of wounds warrants a more structured approach and proportionate investment in wound care, education, and related research.
544 citations
TL;DR: The quality of intervention studies intended to increase hand hygiene compliance remains disappointing and although multifaceted campaigns with social marketing or staff involvement appear to have an effect, there is insufficient evidence to draw a firm conclusion.
503 citations
01 Feb 2019
TL;DR: A 2018 retrospective analysis of Medicare beneficiaries identified that ∼8.2 million people had wounds with or without infections as discussed by the authors, and the highest expenses were for surgical wounds followed by diabetic foot ulcers, with a higher trend toward costs associated with outpatient wound care compared with inpatient.
Abstract: Significance: A 2018 retrospective analysis of Medicare beneficiaries identified that ∼8.2 million people had wounds with or without infections. Medicare cost estimates for acute and chronic wound treatments ranged from $28.1 billion to $96.8 billion. Highest expenses were for surgical wounds followed by diabetic foot ulcers, with a higher trend toward costs associated with outpatient wound care compared with inpatient. Increasing costs of health care, an aging population, recognition of difficult-to-treat infection threats such as biofilms, and the continued threat of diabetes and obesity worldwide make chronic wounds a substantial clinical, social, and economic challenge. Recent Advances: Chronic wounds are not a problem in an otherwise healthy population. Underlying conditions ranging from malnutrition, to stress, to metabolic syndrome, predispose patients to chronic, nonhealing wounds. From an economic point of view, the annual wound care products market is expected to reach $15-22 billion by 2024. The National Institutes of Health's (NIH) Research Portfolio Online Reporting Tool (RePORT) now lists wounds as a category. Future Directions: A continued rise in the economic, clinical, and social impact of wounds warrants a more structured approach and proportionate investment in wound care, education, and related research.
95 citations
TL;DR: The use of negative pressure wound therapy resulted in a significantly lower risk of SSIs, and incorporating this intervention in surgical practice can help reduce a complication that significantly increases patient harm and healthcare costs.
Abstract: Objective:This study seeks to evaluate the efficacy of negative pressure wound therapy for surgical-site infection (SSI) after open pancreaticoduodenectomy.Background:Despite improvement in infection control, SSIs remain a common cause of morbidity after abdominal surgery. SSI has been associated wi
79 citations
Cites background or result from "Impact of surgical site infection o..."
...Postoperative complications have been identified as the strongest predictor of increased cost of hospitalization.(10,17,23,24) This has been attributed to prolonged length of hospitalization and need for readmissions in patients developing these complications....
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...com postponement of chemotherapy, increased healthcare costs, and in some cases poor long-term outcomes.(7,10) In the United States alone, the burden of SSIs is estimated at $10 billion per year....
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...This has been attributed to prolonged length of hospitalization and need for readmissions in patients developing these complications.(10) Similar to other studies, in our study SSIs were independently associated with an increased cost of hospitalization....
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TL;DR: The administration of oral antibiotics as prophylaxis the day before colon surgery significantly reduces the incidence of surgical-site infections without mechanical bowel preparation and should be routinely adopted before elective colon surgery.
72 citations
References
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TL;DR: The definition of surgical wound infection was modified and the name was changed to surgical site infection (SSI) after the NNIS System hospitals had had considerable experience with the definitions.
Abstract: In 1988, the Centers for Disease Control (CDC) published definitions of nosocomial infections However, because of journalistic style and space constraints, these definitions lacked some of the detail provided to National Nosocomial Infections Surveillance (NNIS) System hospitals in the NNIS Manual (unpublished). After the NNIS System hospitals had had considerable experience with the definitions and in response to a request for review by The Surgical Wound Infection Task Force, a group composed of members of The Society for Hospital Epidemiology of America, the Association for Practitioners in Infection Control, the Surgical Infection Society, and the CDC, we slightly modified the definition of surgical wound infection and changed the name to surgical site infection (SSI).
1,811 citations
TL;DR: A risk index was developed to predict a surgical patient's risk of acquiring an SWI as mentioned in this paper, ranging from 0 to 3, is the number of risk factors present among the following: a patient with an American Society of Anesthesiologists preoperative assessment score of 3, 4, or 5, an operation classified as contaminated or dirty-infected, and an operation lasting over T hours, where T depends upon the operative procedure being performed.
1,369 citations
TL;DR: Estimates of the burden of hospital-acquired infections occurring in adult patients admitted to similar specialties at NHS hospitals in England were derived from the results of this study.
460 citations
TL;DR: In this article, the authors report that the adverse impact of surgical site infection differs greatly for different categories of surgery, and highlight the importance of measuring the impact for defined categories rather than for all SSIs and all surgical procedures.
456 citations
TL;DR: The aim of this review of recent studies on surgical site infections was to compare methods of cost research and magnitudes of costs due to SSI.
370 citations