Effect of postdischarge surveillance on rates of infectious complications after cesarean section

Decreases in length of stay for surgical procedures and increased outpatient surgery affect accuracy of surgical wound infection rates. To assess accuracy of rates for infectious complications after delivery by cesarean section, we implemented postdischarge surveillance at our hospital (4800 annual deliveries). Physician questionnaires were used. Response rate was greater than 90%. During the 5 months before postdischarge surveillance the overall infection rate was 1.6%; afterward the rate increased to 6.3% (p = 0.0003). Approximately 59% of infectious complications would have gone undetected with only inpatient surveillance. We conclude that postdischarge surveillance is necessary for an accurate determination of rates of infectious complications. The need among this population reflects relatively short postpartum hospitalization and emphasis on outpatient management of postoperative complications.