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Hospital-Related Determinants For Surgical-Site Infection Following Hip Arthroplasty

Published online by Cambridge University Press:  21 June 2016

Eveline L. P. E. Geubbels
Affiliation:
Department of Infectious Diseases Epidemiology, National Institute of Public Health and the Environment (RIVM), Bilthoven, the Netherlands
Jan C. Wille*
Affiliation:
Dutch Institute for Healthcare Improvement CBO, Utrecht, the Netherlands
Nico J. D. Nagelkerke
Affiliation:
Department of Computerization and Methodological Consultancy, National Institute of Public Health and the Environment (RIVM), Bilthoven, the Netherlands
Christina M. J. E. Vandenbroucke-Grauls
Affiliation:
Department of Medical Microbiology and Infection Control, Vrije Universiteit Medical Center, Amsterdam, the Netherlands
Diederick E. Grobbee
Affiliation:
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
Annette S. de Boer
Affiliation:
Department of Infectious Diseases Epidemiology, National Institute of Public Health and the Environment (RIVM), Bilthoven, the Netherlands
*
Dutch Institute for Healthcare Improvement CBO, PO Box 20064, 3502 LB, Utrecht, the Netherlands. j.uiille@cbo.nl

Abstract

Objective:

To determine hospital-related risk factors for surgical-site infection (SSI) following hip arthroplasty.

Design:

Prospective, multicenter cohort study based on surveillance data and data collected through a structured telephone interview. With the use of multilevel logistic regression, the independent effect of hospital-related characteristics on SSI was assessed.

Setting:

Thirty-six acute care hospitals in the Dutch surveillance network for nosocomial infections (PREZIES), from 1996 to 2000.

Patients:

Thirteen thousand six hundred eighty patients who underwent total or partial hip arthroplasty.

Results:

A high annual volume of operations was associated with a reduced risk of SSI (risk-adjusted risk ratio [RR] per 50 extra operations, 0.85; 95% confidence interval [CI95], 0.74–0.97). With each extra full-time–equivalent infection control staff member per 250 beds available for prevention of SSI, the risk for SSI was decreased (RR, 0.48; CI95, 0.16–1.44), although the decrease was not statistically significant. Hospital size, teaching status, university affiliation, and number of surgeons and their years of experience showed no important association with the risk of SSI.

Conclusion:

Undergoing surgery in a hospital with a low volume of operations increases a patient's risk of SSI.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2005

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References

1.Geubbels, EL, Mintjes-de Groot, AJ, van den Berg, JM, de Boer, AS. An operating surveillance system of surgical-site infections in the Netherlands: results of the PREZIES national surveillance network. Pre-ventie van Ziekenhuisinfecties door Surveillance. Infect Control Hosp Epidemiol 2000;21:311318.CrossRefGoogle ScholarPubMed
2.Kirkland, KB, Briggs, JP, Trivette, SL, Wilkinson, WE, Sexton, DJ. The impact of surgical-site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs. Infect Control Hosp Epidemiol 1999;20:725730.CrossRefGoogle Scholar
3.Mangram, AJ, Horan, TC, Pearson, ML, Silver, LC, Jarvis, WR. Guideline for prevention of surgical site infection, 1999: Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol 1999;20:250280.CrossRefGoogle ScholarPubMed
4.Haley, RW. Measuring the intrinsic risk of wound infection in surgical patients. Problems in General Surgery 1993;10:396417.Google Scholar
5.Roy, MC, Perl, TM. Basics of surgical-site infection surveillance. Infect Control Hosp Epidemiol 1997;18:659668.CrossRefGoogle ScholarPubMed
6.Lee, TB, Baker, OG, Lee, JT, Scheckler, WE, Steele, L, Laxton, CE. Recommended practices for surveillance: Association for Professionals in Infection Control and Epidemiology, Surveillance Initiative Working Group. Am J Infect Control 1998;26:277288.CrossRefGoogle ScholarPubMed
7.Wong, ES. Surgical site infections. In: Mayhall, CG, ed. Hospital Epidemiology and Infection Control. Baltimore: Williams & Wilkins; 1996:154175.Google Scholar
8.Haley, RW, Culver, DH, White, JW, et al. The efficacy of infection surveillance and control programs in preventing nosocomial infections in US hospitals. Am J Epidemiol 1985;121:182205.CrossRefGoogle ScholarPubMed
9.Farber, BF, Wenzel, RP. Postoperative wound infection rates: results of prospective statewide surveillance. Am J Surg 1980:140:343346.CrossRefGoogle ScholarPubMed
10.Lau, WY, Fan, ST, Chu, KW, Yip, WC, Yuen, WC, Wong, KK. Influence of surgeons' experience on postoperative sepsis. Am J Surg 1988;155:322326.CrossRefGoogle ScholarPubMed
11.Gastmeier, P, Kampf, G, Wischnewski, N, et al. Prevalence of nosocomial infections in representative German hospitals. J Hosp Infect 1998;38:3749.CrossRefGoogle ScholarPubMed
12.Schifman, RB, Howanitz, PJ. Nosocomial infections: a college of American pathologists Q-probes study in 512 North American institutions. Arch Pathol Lab Med 1994;118:115119.Google Scholar
13.Horan, TC, Gaynes, RP, Martone, WJ, Jarvis, WR, Emori, TG. CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. Infect Control Hosp Epidemiol 1992;13:606608.CrossRefGoogle ScholarPubMed
14.Garner, JS, Jarvis, WR, Emori, TG, Horan, TC, Hughes, JM. CDC definitions for nosocomial infections, 1988. Am JInfect Control 1988;16:128140.CrossRefGoogle Scholar
15.Owens, WD, Felts, JA, Spitznagel, EL. ASA physical status classifications: a study of consistency of ratings. Anesthesiology 1978:49:239243.CrossRefGoogle ScholarPubMed
16.Altemeier, WA, Burke, JF, Pruitt, BA, Sandusky, WR. Manual on Control of Infection in Surgical Patients, ed. 2. Philadelphia: J. B. Lippincott; 1984.Google Scholar
17.Hox, JJ. Applied Multilevel Analysis. Amsterdam: TT-Publikaties; 1995.Google Scholar
18.Greenland, S, Rothman, KJ. Fundamentals of epidemiologic data analysis. In: Rothman, KJ, Greenland, S, eds. Modern Epidemiology, ed. 2. Philadelphia: Lippincott-Raven; 1998:216217.Google Scholar
19.Rice, N, Leyland, A. Multilevel models: applications to health data. Journal of Health Services Research & Policy 1996;1:154164.Google ScholarPubMed
20.Khuri, SF, Daley, J, Henderson, W, et al. Relation of surgical volume to outcome in eight common operations: results from the VA National Surgical Quality Improvement Program. Ann Surg 1999;230:414432.CrossRefGoogle ScholarPubMed
21.Schrag, D, Cramer, LD, Bach, PB, Cohen, AM, Warren, JL, Begg, CB. Influence of hospital procedure volume on outcomes following surgery for colon cancer. JAMA 2000;284:30283035.CrossRefGoogle Scholar
22.Roohan, PJ, Bickell, NA, Baptiste, MS, Therriault, GD, Ferrara, EP, Siu, AL. Hospital volume differences and five-year survival from breast cancer. Am J Public Health 1998;88:454457.CrossRefGoogle ScholarPubMed
23.Bach, PB, Cramer, LD, Schrag, D, Downey, RJ, Gelfand, SE, Begg, CB. The influence of hospital volume on survival after resection for lung cancer. N Engl J Med 2001;345:181188.CrossRefGoogle ScholarPubMed
24.Laffel, GL, Barnett, Al, Finkelstein, S, Kaye, MP. The relation between experience and outcome in heart transplantation. N Engl J Med 1992;327:12201225.CrossRefGoogle ScholarPubMed
25.Begg, CB, Cramer, LD, Hoskins, WJ, Brennan, ME. Impact of hospital volume on operative mortality for major cancer surgery. JAMA 1998;280:17471751.CrossRefGoogle Scholar
26.Sosa, JA, Bowman, HM, Gordon, TA, et al. Importance of hospital volume in the overall management of pancreatic cancer. Ann Surg 1998;228:429438.CrossRefGoogle ScholarPubMed
27.Hughes, RG, Hunt, SS, Luft, HS. Effects of surgeon volume and hospital volume on quality of care in hospitals. Med Care 1987;25:489503.CrossRefGoogle ScholarPubMed
28.Geubbels, ELPE, Nagelkerke, NJD, Mintjes-de Groot, AJ, Vandenbroucke-Grauls, CMJE, Grobbee, DE, de Boer, AS. Reduced risk of surgical site infection through surveillance in a network. Submitted for publication.Google Scholar
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