1. An interventional nationwide surveillance program lowers postoperative infection rates in elective colorectal surgery. A cohort study (2008-2019)
- Author
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Arroyo-García, Nares, Badia, Josep M., Vázquez, Ana, Pera Roman, Miguel, Parés, David, Limón, Enric, Almendral, Alexander, Piriz, Marta, Cecilia, Díez, Fraccalvieri, Domenico, López Contreras, Joaquín, Pujol, Miquel, Colorectal Surveillance Team, VINCat Program, Arroyo-García, Nares, Badia, Josep M., Vázquez, Ana, Pera Roman, Miguel, Parés, David, Limón, Enric, Almendral, Alexander, Piriz, Marta, Cecilia, Díez, Fraccalvieri, Domenico, López Contreras, Joaquín Pujol, Miquel, Colorectal Surveillance Team, VINCat Program, [Arroyo-Garcia N, Badia JM] Department of Surgery, Hospital General Granollers, Granollers, Spain. School of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain. [Vázquez A] Servei d’Estadística Aplicada, Universitat Autònoma de Barcelona, Bellaterra, Spain. [Pera M] Department of Surgery, Hospital del Mar, Barcelona, Spain. [Parés D] Department of Surgery, Hospital Universitari Germans Trias i Pujol, Badalona, Spain. [Limón E] VINCat Program, Universitat de Barcelona, Barcelona, Spain, and Hospital General de Granollers
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Prevenció i control ,Infeccions quirúrgiques ,Cirurgia colorectal ,Surgical wound infection ,Estudios de cohortes ,Infection control ,Còlon - Cirurgia ,Cohort Studies ,Health Occupations::Medicine::Specialties, Surgical::Colorectal Surgery [DISCIPLINES AND OCCUPATIONS] ,Cirugía colorrectal ,Control d'infeccions ,Prevención y control ,Colorectal surgery ,Risk Factors ,Infección del sitio quirúrgico ,Humans ,Surgical Wound Infection ,Estudis de cohorts ,Epidemiologia ,Proporción de infección estandarizada ,Digestive System Surgical Procedures ,Standardized infection ratio ,Infecció del lloc quirúrgic ,Adverse effects ,Prevention & control ,Infeccions quirúrgiques - Estudi de casos ,Cirurgia colorrectal ,General Medicine ,Efectos adversos ,Infección de la herida quirúrgica ,Elective Surgical Procedures ,profesiones sanitarias::medicina::especialidades quirúrgicas::cirugía colorrectal [DISCIPLINAS Y OCUPACIONES] ,Ratio d'infecció estandarditzat ,Surgery ,Efectes adversos ,Colorectal Surgery ,Surgical site infection ,Infecció de ferides quirúrgiques - Abstract
Colorectal surgery; Postoperative infection; Cohort studies Cirugía colorrectal; Infección postoperatoria; Estudios de cohortes Cirurgia colorectal; Infecció postoperatòria; Estudis de cohorts Background: Colorectal surgery is associated with the highest rate of surgical site infection (SSI). This study analyses the effectiveness of an interventional surveillance program on SSI rates after elective colorectal surgery. Material and methods: Cohort study showing temporal trends of SSI rates and Standardized Infection Ratio (SIR) in elective colorectal surgery over a 12-year period. Prospectively collected data of a national SSI surveillance program was analysed and the effect of specific interventions was evaluated. Patient and procedure characteristics, as well as SIR and SSI rates were stratified by risk categories and type of SSI analysed using stepwise multivariate logistic regression models. Results: In a cohort of 42,330 operations, overall cumulative SSI incidence was 16.31%, and organ-space SSI (O/S-SSI) was 8.59%. There was a 61.63% relative decrease in SSI rates (rho = -0.95804). The intervention which achieved the greatest SSI reduction was a bundle of 6 measures. SSI in pre-bundle period was 19.73% vs. 11.10% in post-bundle period (OR 1.969; IC 95% 1.860-2.085; p < 0.0001). O/S-SSI were 9.08% vs. 6.06%, respectively (OR 1.547; IC 95% 1.433-1.670; p < 0.0001). Median length of stay was 7 days, with a significant decrease over the studied period (rho = -0.98414). Mortality of the series was 1.08%, ranging from 0.35% to 2.0%, but a highly significant decrease was observed (rho = -0.67133). Conclusions: Detailed analysis of risk factors and postoperative infection in colorectal surgery allows strategies for reducing SSI incidence to be designed. An interventional surveillance program has been effective in decreasing SIR and SSI rates.
- Published
- 2021