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Infectious complications after elective vascular surgical procedures.
Todd R Vogel1, Viktor Y Dombrovskiy, Jeffrey L Carson
1Division of Vascular Surgery, The Surgical Outcomes Research Group, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, NJ 08903-0019, USA. vogelto@umdnj.edu
Journal of Vascular Surgery
|December 4, 2009
Summary
Postoperative infection rates after elective vascular surgery vary by procedure type, with open aortic surgery posing the highest risk. Identifying high-risk patients and procedures can reduce complications and healthcare costs.
Area of Science:
- Vascular Surgery
- Infectious Complications
- Health Care Resource Utilization
Background:
- Postoperative infectious complications are a significant concern following elective vascular surgery.
- Understanding procedural risks and patient factors is crucial for infection prevention.
Purpose of the Study:
- To evaluate and compare postoperative infectious complication and death rates after elective vascular surgery.
- To identify vascular procedures with the highest risk of nosocomial infections.
- To assess the impact of infection on healthcare resource utilization.
Main Methods:
- Analysis of the Nationwide Inpatient Sample (2002-2006) for major vascular procedures.
- Identification of infectious complications including pneumonia, urinary tract infections (UTI), postoperative sepsis, and surgical site infections (SSI).
- Calculation of case-mix-adjusted rates using multivariate logistic regression and indirect standardization.
Main Results:
- Overall postoperative infection rate was 3.70% across 870,778 procedures.
- Open abdominal aortic surgery had the highest infection rate; head and neck endarterectomy had the lowest.
- Infectious complications were higher in octogenarians, women, and Black patients, significantly increasing hospital stay and costs.
Conclusions:
- Elective vascular procedures have varying risks for postoperative infection, with open aortic surgery being highest.
- Women, octogenarians, and Black individuals face increased risk; disparities exist in larger and teaching hospitals.
- Reducing nosocomial complications in high-risk procedures can lead to significant cost savings.
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