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Report card on Surgical Care Improvement Project (SCIP): nationwide inpatient sample infection data 2001-2006
John Mihran Davis1, Yen-Hong Kuo, Nasim Ahmed
1Department of Surgery, Jersey Shore University Medical Center, Robert Wood Johnson Medical School, Neptune, New Jersey, USA. jmdavis@meridianhealth.com
Background:
The administration of appropriate antibiotics in a timely fashion with discontinuation post-operatively is the first of the Surgical Care Improvement Project (SCIP) initiatives and was expected to reduce post-operative infections significantly. This study aimed at determining whether SCIP has had an effect on surgical site infections (SSIs).
Methods:
A retrospective cohort study was conducted to evaluate the infection rates of adult patients (age≥18 years) having elective cholecystectomies, laparoscopic cholecystectomies, and colectomies from 2001-2006 using the Nationwide Inpatient Sample (NIS) database. The population consisted of all patients older than 18 years who had colon resection or cholecystectomy and were discharged from a hospital included in the NIS. Annual infection rates were determined for each of the operations.
Results:
Post-operative infections rose steadily and significantly (p<0.0001) in colon surgery from 2001 to 2006. A significant increase in SSIs also was seen in open (p=0.0001) and laparoscopic (p<0.0001) cholecystectomy from 2001 to 2006. Length of stay was significantly longer in infected than in non-infected patients.
Conclusion:
The factors that contributed to the observed increase in the infection rate should be identified to improve the SCIP initiatives.
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