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[4-year experiences with computer-assisted registration of postoperative wound infections and identification of risk
A Bremmelgaard1, A M Sørensen, E Brems-Dalgaard
1Frederiksberg Hospital, klinisk mikrobiologisk afdeling.
Abstract:
A continuous record of postoperative surgical infections was carried out by electronic data processing of 9,181 orthopaedic and general operations. The overall infection rate was 5.7%, ranging from 2.0% (clean wounds) to 22.1% (dirty wounds). The corresponding deep infection rates were 1.7%, 0.4% and 5.4%, respectively. Employing a multiple logistic regression analysis, ten risk factors were evaluated. Factors found to be significant for both departments were: wound contamination, duration of operation and age. In addition, in the department of orthopaedic surgery: date of operation and surgeon, and in the department of general surgery: planning of operation, length of preoperative stay and anatomic groups. Sex had no influence on postoperative infection. Significant factors altered during the four years. Postoperative stay was, on an average, 13.9 days longer in infected patients.
Insights
Postoperative surgical infection rates vary by wound type, with dirty wounds posing the highest risk. Key factors influencing infection include wound contamination, operation duration, and patient age.
Area of Science:
- Surgical infection surveillance
- Epidemiology of surgical site infections
- Healthcare data analysis
Background:
- Postoperative surgical infections pose a significant risk to patient outcomes.
- Accurate surveillance is crucial for identifying infection trends and risk factors.
- Electronic data processing offers a robust method for continuous monitoring.
Purpose of the Study:
- To continuously monitor postoperative surgical infection rates.
- To identify significant risk factors for surgical site infections (SSIs) in orthopaedic and general surgery.
- To analyze trends in SSIs over a four-year period.
Main Methods:
- Electronic data processing of 9,181 orthopaedic and general surgical operations.
- Calculation of overall and deep infection rates based on wound classification (clean, contaminated, dirty).
- Multiple logistic regression analysis to evaluate ten potential risk factors for infection.
Main Results:
- Overall infection rate was 5.7%, with rates ranging from 2.0% (clean) to 22.1% (dirty wounds).
- Significant risk factors for both departments included wound contamination, operation duration, and patient age.
- Department-specific factors also identified: orthopaedics (date, surgeon), general surgery (operation planning, preoperative stay, anatomic group).
- Sex was not a significant factor; risk factors evolved over four years.
- Infected patients had an average of 13.9 days longer postoperative stay.
Conclusions:
- Wound contamination, operation duration, and patient age are critical predictors of SSIs.
- Surveillance data can guide targeted interventions to reduce infection rates.
- Understanding specific risk factors is essential for optimizing surgical safety in different departments.