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Infecciones en el sitio quirúrgico después de procedimientos de cirugía ambulatoria
Pamela L Owens1, Marguerite L Barrett2, Susan Raetzman3
1Center for Delivery, Organization and Markets, Agency for Healthcare Research and Quality, Rockville, Maryland.
JAMA
|February 20, 2014
Resumen
Las infecciones del sitio quirúrgico clínicamente significativas (CS-SSIs) después de la cirugía ambulatoria son poco frecuentes, pero representan un número notable de eventos adversos. Las iniciativas de mejora de la calidad son cruciales para reducir estas infecciones graves.
Área de la Ciencia:
- La investigación de resultados quirúrgicos en la investigación de resultados quirúrgicos.
- Epidemiología de las enfermedades infecciosas.
- Servicios de salud investigación servicios de salud.
Sus antecedentes:
- Las infecciones del sitio quirúrgico (SSI) son una causa significativa de morbilidad en entornos de pacientes hospitalizados.
- Los datos sobre infecciones graves después de la cirugía ambulatoria son limitados.
- Comprender las tasas de CS-SSI en cirugía ambulatoria es crucial para la seguridad del paciente.
Objetivo del estudio:
- Para determinar la incidencia de infecciones del sitio quirúrgico clínicamente significativas (CS-SSIs) después de cirugía ambulatoria de bajo a moderado riesgo.
- Identificar la tasa de visitas de cuidados agudos posquirúrgicos para CS-SSIs en una población de pacientes grande y diversa.
Principales métodos:
- Análisis retrospectivo de 284.098 procedimientos quirúrgicos ambulatorios en 8 estados de EE.UU. en 2010.
- Inclusión de pacientes adultos con bajo riesgo quirúrgico sometidos a cirugía general, cirugía ortopédica, neuroquirúrgica, ginecológica o procedimientos urológicos.
- Evaluación de las visitas de cuidados agudos posquirúrgicos de 14 y 30 días para CS-SSIs.
Principales resultados:
- La incidencia de CS-SSIs que requieren visitas de cuidados agudos fue de 3,09 por 1000 procedimientos a los 14 días y de 4,84 por 1000 a los 30 días.
- Dos tercios de las visitas del CS-SSI se produjeron dentro de los 14 días, con un 93,2% que requirió tratamiento hospitalario.
- En general, las visitas de cuidados agudos posquirúrgicos (incluyendo CS-SSIs) fueron de 19,99 por 1000 en 14 días y 33,62 por 1000 en 30 días.
Conclusiones:
- Si bien las tasas de CS-SSIs son bajas después de la cirugía ambulatoria, constituyen un agregado sustancial de resultados adversos.
- Estas infecciones graves justifican esfuerzos centrados en la mejora de la calidad.
- Minimizar CS-SSIs en cirugía ambulatoria es esencial para mejorar la seguridad del paciente y los resultados.
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