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Surgical site infections in outpatient surgeries: Less invasive procedures contribute substantially to the overall

Katherine Linsenmeyer1,2, Westyn Branch-Elliman1,3,4, Emily Kalver3

  • 1Veterans Affairs Boston Healthcare System, Boston, Massachusetts.

Infection Control and Hospital Epidemiology
|August 21, 2019
PubMed

Insights

More than half of outpatient surgeries at risk for adverse events were excluded from surgical site infection (SSI) surveillance. The burden of SSI was similar in both eligible and ineligible groups, suggesting a need to re-evaluate outpatient surveillance strategies.

Area of Science:

  • Healthcare Quality
  • Infectious Disease Surveillance
  • Surgical Outcomes

Background:

  • Surgical site infections (SSIs) are a significant concern in healthcare.
  • Current surveillance methods may not capture all at-risk outpatient surgeries.
  • Veterans Affairs Surgical Quality Improvement Program (VASQIP) uses specific eligibility criteria.

Purpose of the Study:

  • To evaluate the impact of Veterans Affairs Surgical Quality Improvement Program (VASQIP) eligibility criteria on surgical site infection (SSI) surveillance in outpatient settings.
  • To compare the burden of SSIs between eligible and ineligible outpatient surgeries.

Main Methods:

  • Analysis of outpatient surgeries based on VASQIP eligibility criteria.
  • Inclusion of clinician determination of invasiveness in defining eligibility.
  • Comparison of SSI burden for eligible versus ineligible surgical cases.

Main Results:

  • Over 50% of outpatient surgeries with a higher predicted risk of adverse events were excluded from SSI surveillance.
  • The burden of SSIs was found to be similar between surgeries eligible and ineligible for surveillance.
  • Current VASQIP criteria may lead to underestimation of SSI risk in the outpatient setting.

Conclusions:

  • Existing SSI surveillance practices in outpatient settings, based on VASQIP criteria, may be inadequate.
  • Re-evaluation of surveillance strategies is necessary to ensure comprehensive monitoring of SSIs.
  • A broader approach to outpatient SSI surveillance is recommended.

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