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ANALYSIS OF SURGICAL SITE INFECTIONS IN PEDIATRIC PATIENTS AFTER ORTHOPEDIC SURGERY: A CASE-CONTROL STUDY
Mariana de Queiroz Leite Chagas1, Ana Maria Magalhães Costa2, Pedro Henrique Barros Mendes2
1Instituto Nacional de Traumatologia e Ortopedia Jamil Haddad - Ministério da Saúde, Rio de Janeiro, RJ, Brasil.
Insights
The surgical site infection rate in pediatric orthopedic surgery was 2.88%. Infections were more common in older children, those with implants, and longer hospital stays, highlighting key surveillance factors.
Area of Science:
- Pediatric Orthopedic Surgery
- Infectious Disease Epidemiology
- Healthcare Quality Improvement
Background:
- Surgical site infections (SSIs) are a significant concern in pediatric orthopedic surgery.
- Understanding risk factors is crucial for preventing SSIs in this vulnerable population.
- Centers of excellence aim to provide high-quality care, necessitating robust infection surveillance.
Purpose of the Study:
- To determine the incidence of surgical site infections (SSIs) in children undergoing orthopedic surgery.
- To identify patient-specific and procedure-related risk factors associated with SSIs.
- To analyze patient profiles to enhance epidemiological surveillance of SSIs.
Main Methods:
- Retrospective analysis of medical records for pediatric orthopedic surgeries over a two-year period.
- Infection cases were matched with non-infected controls based on key demographic and surgical variables.
- Descriptive, bivariate, and correspondence analyses were employed to evaluate patient profiles and risk factors.
Main Results:
- A surgical site infection rate of 2.88% (10 infections out of 347 surgeries) was observed.
- Significant associations were found between SSIs and patient age (over 24 months), surgical implants, extended preoperative periods, and prolonged hospitalization.
- Correspondence analysis identified preoperative period, weight, weight Z-score, age, implant use, procedure type, and hospitalization duration as correlated factors.
Conclusions:
- The overall SSI rate was 2.88%, with increased risk in children over 24 months, those receiving implants, and with longer preoperative and hospital stays.
- Identified variables are critical for establishing effective epidemiological surveillance systems for pediatric SSIs.
- Robust databases and analytical methods are essential for monitoring and improving care quality in pediatric orthopedic surgery.
Objectives:
To describe the rate of surgical site infections in children undergoing orthopedic surgery in centers of excellence and analyze the patients' profiles.
Methods:
Medical records of pediatric patients undergoing orthopedic surgery in the Jamil Haddad National Institute of Traumatology and Orthopedics from January 2012 to December 2013 were analyzed and monitored for one year. Patients diagnosed with surgical site infection were matched with patients without infection by age, date of admission, field of orthopedic surgery and type of surgical procedure. Patient, surgical and follow-up variables were examined. Descriptive, bivariate and correspondence analyses were performed to evaluate the patients' profiles.
Results:
347 surgeries and 10 surgical site infections (2.88%) were identified. There was association of infections with age - odds ratio (OR) 11.5 (confidence interval - 95%CI 1.41-94.9) -, implant - OR 7.3 (95%CI 1.46-36.3) -, preoperative period - OR 9.8 (95%CI 1.83-53.0), and length of hospitalization - OR 20.6 (95%CI 3.7-114.2). The correspondence analysis correlated the infection and preoperative period, weight, weight Z-score, age, implant, type of surgical procedure, and length of hospitalization. Average time to diagnosis of infection occurred 26.5±111.46 days after surgery.
Conclusions:
The rate of surgical site infection was 2.88%, while higher in children over 24 months of age who underwent surgical implant procedures and had longer preoperative periods and lengths of hospitalization. This study identified variables for the epidemiological surveillance of these events in children. Available databases and appropriate analysis methods are essential to monitor and improve the quality of care offered to the pediatric population.
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