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[Frequency of postoperative wound infections: an unsuitable parameter for comparison of hospitals]
T van Dalen1, S van Ruth, Y van Dijk
1Afd. Chirurgie, Thans: Universitair Medisch Centrum, Utrecht.
Objective:
To evaluate the reliability of registration of wound infections and their contribution to total postoperative morbidity.
Design:
Prospective.
Method:
During the period from 1 July 1997 through 30 June 1998 of all patients treated in the department of Surgery of the Diaconessen Hospital, Utrecht, the treatment-related complications were recorded during the hospital stay as well as at the first outpatient follow-up. The clinical registration forms were checked and supplemented after discharge, during the transfer and by the hospital hygienist. The precision of registration, the implications of the registered wound infections, and the share of this complication in overall postoperative morbidity were studied.
Results:
There were 2172 admissions (2004 patients): 996 males and 1176 females (mean age at admission 55 years). The response of registration was 100% during hospital stay and 59.5% in the outpatient department. Postoperative course was complicated in 506 patients (23% of the admissions). Of the 735 registered complications 583 (79%) were recorded during clinical stay. Airway and wound infections were the most frequently registered complications (in 4.4% and 4.3% of the admissions respectively). Of the wound infections 45% were recorded after discharge and 88% fully recovered by conservative means. Both the frequency of wound infections in relation to other postoperative complications and the severity of the registered wound infections varied with the reason of admission.
Conclusion:
The incidence of postoperative wound infections was not reliably measured as a result of low response of registration after hospital discharge. The contribution of wound infections to overall postoperative morbidity and the severity of these infections varied with the reason of admission.
Insights
Reliable measurement of postoperative wound infections is challenging due to incomplete registration after hospital discharge. Their impact on patient morbidity varies significantly based on the reason for admission.
Area of Science:
- Medical research
- Surgical outcomes
- Infection control
Background:
- Postoperative complications significantly impact patient recovery and healthcare costs.
- Accurate assessment of surgical site infections (SSIs) is crucial for quality improvement initiatives.
Purpose of the Study:
- To assess the reliability of wound infection registration in a hospital setting.
- To determine the contribution of wound infections to overall postoperative morbidity.
Main Methods:
- A prospective study was conducted over one year, recording complications during hospitalization and outpatient follow-up.
- Clinical registration forms were verified and supplemented by a hospital hygienist.
- Data analysis focused on registration precision, wound infection implications, and their share in overall morbidity.
Main Results:
- Out of 2172 admissions, 23% experienced complicated postoperative courses.
- Wound infections were frequently registered (4.3% of admissions), with 45% identified post-discharge.
- The incidence and severity of wound infections varied based on the reason for admission.
Conclusions:
- Incomplete registration after discharge compromises the accurate incidence measurement of postoperative wound infections.
- The impact of wound infections on postoperative morbidity is variable and depends on patient admission reasons.