nach oben

Erschienen in:

01.07.2012 | Original Article

Impact of surgical site infection after colorectal surgery on hospital stay and medical expenditure in Japan

verfasst von: Nobuichi Kashimura, Shinya Kusachi, Toshiro Konishi, Junzo Shimizu, Masato Kusunoki, Masaaki Oka, Toshiro Wakatsuki, Yoshinobu Sumiyama

Erschienen in: Surgery Today | Ausgabe 7/2012

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To clarify the impact of surgical site infection (SSI) after colorectal surgery on the length of hospital stay and medical expenditure in Japan.

Methods

This was a multi-center, retrospective-matched case–control study.

Results

The total number of patients enrolled was 334 (167 case/control pairs). The average hospital stay after surgery was prolonged by 17.8 days (95% CI 11.9–23.5) and the average medical cost after surgery was increased by $5,938 (95% CI 3,610–8,367) in the SSI group versus the non-SSI group. Hospital charges comprised the largest among all cost categories and accounted for 53% of the additional cost. The hospital stay and medical costs both increased proportionately to the depth of the SSI, from 4.4 days and $608 for superficial incisional SSI, to 39.2 days and $14,448 for organ/space SSI. SSI caused by MRSA prolonged the hospital stay by 19.3 days and incurred an additional cost of $7,015.

Conclusions

SSI clearly prolonged the hospital stay and increased medical costs. The numerical values revealed by this study reinforce the medical-economic importance of instigating preventive measures against SSI.

Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for prevention of surgical site infection 1999. Infect Control Hosp Epidemiol. 1999;20:247–78.CrossRef

Smyth ET, Emmerson AM. Surgical site infection surveillance. J Hosp Infect. 2000;45:173–84.PubMedCrossRef

Anderson DJ, Kaye KS, Classen D, Arias KM, Podgorny K, Burstin H, et al. Strategies to prevent surgical site infections in acute care hospitals. Infect Control Hosp Epidemiol. 2008;29:S51–61.PubMedCrossRef

de Lissovoy G, Fraeman K, Hutchins V, Murphy D, Song D, Vaughn BB. Surgical site infection: incidence and impact on hospital utilization and treatment costs. Am J Infect Control. 2009;37:387–97.PubMedCrossRef

Suljagic V, Jevtic M, Djordjevic B, Jovelic A. Surgical site infections in a tertiary health care center: prospective cohort study. Surg Today. 2010;40:763–71.PubMedCrossRef

Leaper DJ, van Goor H, Reilly J, Petrosillo N, Geiss HK, Torres AJ, et al. Surgical site infection—a European perspective of incidence and economic burden. Int Wound J. 2004;1:247–73.PubMedCrossRef

Weber WP, Zwahlen M, Reck S, Feder-Mengus C, Misteli H, Rosenthal R, et al. Economic burden of surgical site infection at a European university hospital. Infect Control Hosp Epidemiol. 2008;29:623–9.PubMedCrossRef

Defez C, Fabbro-Peray P, Cazaban M, Boudemaghe T, Sotto A, Daures JP. Additional direct medical costs of nosocomial infections: an estimation from a cohort of patients in a French university hospital. J Hosp Infect. 2008;68:130–6.PubMedCrossRef

Fry DE. The economic costs of surgical site infection. Surg Infect. 2002;3:37–43.CrossRef

10.

Yasunaga H, Ide H, Imamura K, Ohe K. Accuracy of economic studies on surgical site infection. J Hosp Infect. 2007;65:102–7.PubMedCrossRef

11.

Broex ECJ, van Asselt ADI, Bruggeman CA, van Tiel FH. Surgical site infections: how high are the costs? J Hosp Infect. 2009;72:193–201.PubMedCrossRef

12.

Kashimura N. SSI prevention and its medico economic effect (in Japanese with English abstract). Nihon Gekakansensyo Gakkaizasshi (J Jpn Soc Surg Infect). 2005;2:67–72.

13.

Kashimura N, Nakamura F, Anbo Y. Coverage of SSI in DPC (in Japanese with English abstract). Nihon Gekakansensyo Gakkaizasshi (J Jpn Soc Surg Infect). 2009;6:163–8.

14.

Kirkland KB, Briggs JP, Trivette SL, Wilkinson WE, Sexton DJ. The impact of surgical site infections in the1990s: attributable mortality, excess length of hospitalization, and extra costs. Infect Control Hosp Epidemiol. 1999;20:725–30.PubMedCrossRef

15.

Coello R, Charlett A, Wilson J, Ward V, Pearson A, Borriello P. Adverse impact of surgical site infections in English hospitals. J Hosp Infect. 2005;60:93–103.PubMedCrossRef

16.

Mahmoud NN, Turpin RS, Yang G, Saunders WB. Impact of surgical site infections on length of stay and costs in selected colorectal procedures. Surg Infect. 2009;10:539–44.CrossRef

17.

Tanner J, Khan D, Aplin C, Ball J, Thomas M, Bankart J. Post-discharge surveillance to identify colorectal surgical site infection rates and related costs. J Hosp Infect. 2009;72:243–50.PubMedCrossRef

18.

Zoustman D, McDonald S, Vethanayagan D. Total and attributable costs of surgical wound infections at a Canadian tertiary care center. Infect Control Hosp Epidemiol. 1998;19:254–9.CrossRef

19.

Plowman R, Graves N, Griffin MAS, Roberts JA, Swan AV, Cookson B, et al. The rate and cost of hospital acquired infections occurring in patients admitted to selected specialties of a district general hospital in England and the national burden imposed. J Hosp Infect. 2001;47:198–209.PubMedCrossRef

20.

Alfonso JL, Pereperez SB, Canoves JM, Martinez MM, Martinez IM, Martin-Moreno JM. Are we really seeing the total costs of surgical site infection? A Spanish study. Wound Repair Regen. 2007;15:474–81.PubMedCrossRef

21.

Dobson MW, Geniel Geisler DG, Victor Fazio VF, Feza Remzi FR, Tracy Hull TH, Jon Vogel JV. Minimally invasive surgical wound infections: Laparoscopic surgery decreases morbidity of surgical site infections and decreases the cost of wound care. Colorectal Dis. 2010;29. doi:10.1111/j.1463-1318.2010.02302.x.

22.

Anderson DJ, Kaye KS. Staphylococcal surgical site infections. Infect Dis Clin North Am. 2009;23:53–72.PubMedCrossRef

23.

Kaye KS, Anderson DJ, Sloane R, Chen LF, Choi Y, Link K, et al. The impact of surgical site infection on older operative patients. J Am Geriatr Soc. 2009;57:46–54.PubMedCrossRef

24.

Anderson DJ, Kaye KS, Chen LF, Schmader KE, Choi Y, Sexton DJ. Clinical and financial outcomes due to methicillin resistant Staphylococcus aureus surgical site infection: a multi-center matched outcome study. PLos One. 2009;4:e8305, 1–8.

25.

Urban JA. Cost analysis of surgical site infections. Surg Infect. 2006;7:19–22.CrossRef

26.

Mannien J, Wille JC, Snoeren RL, van den Hof S. Impact of postdischarge surveillance on surgical site infection rates for several surgical procedures: results from the nosocomial surveillance network in The Netherlands. Infect Control Hosp Epidemiol. 2006;27:809–16.PubMedCrossRef

27.

Olsen MA, Chu-Ongsakul S, Brandk KE, Dietz JR, Mayfield J, Fraser VJ. Hospital-associated costs due to surgical site infection after breast surgery. Arch Surg. 2008;143:53–60.PubMedCrossRef

28.

Smith RL, Bohl JK, McElearney ST, Friel CM, Barclay MM, Sawyer RG, et al. Wound infection after elective colorectal resection. Ann Surg. 2004;239:599–607.PubMedCrossRef

29.

Perencevich EN, Sands KE, Cosgrove SE, Guadagnoli E, Meara E, Platt R. Health and economic impact of surgical site infections diagnosed after hospital discharge. Emerg Infect Dis. 2003;9:196–203.PubMed

30.

Graves N, Halton K, Doidge S, Clements A, Lairson D, Whitby M. Who bears the cost of healthcare-acquired surgical site infection? J Hosp Infect. 2008;69:274–82.PubMedCrossRef

Titel: Impact of surgical site infection after colorectal surgery on hospital stay and medical expenditure in Japan
verfasst von: Nobuichi Kashimura
Shinya Kusachi
Toshiro Konishi
Junzo Shimizu
Masato Kusunoki
Masaaki Oka
Toshiro Wakatsuki
Yoshinobu Sumiyama
Publikationsdatum: 01.07.2012
Verlag: Springer Japan
Erschienen in: Surgery Today / Ausgabe 7/2012
Print ISSN: 0941-1291
Elektronische ISSN: 1436-2813
DOI: https://doi.org/10.1007/s00595-012-0126-8

Leitlinien kompakt für die Allgemeinmedizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Facharzt-Training Allgemeinmedizin

Die ideale Vorbereitung zur anstehenden Prüfung mit den ersten 24 von 100 klinischen Fallbeispielen verschiedener Themenfelder

Mehr erfahren

Neu im Fachgebiet Allgemeinmedizin

Strenge Blutdruckeinstellung lohnt auch im Alter noch

30.04.2024 Arterielle Hypertonie Nachrichten

Ältere Frauen, die von chronischen Erkrankungen weitgehend verschont sind, haben offenbar die besten Chancen, ihren 90. Geburtstag zu erleben, wenn ihr systolischer Blutdruck < 130 mmHg liegt. Das scheint selbst für 80-Jährige noch zu gelten.

Frauen bekommen seltener eine intensive Statintherapie

30.04.2024 Statine Nachrichten

Frauen in den Niederlanden erhalten bei vergleichbarem kardiovaskulärem Risiko seltener eine intensive Statintherapie als Männer. Ihre LDL-Zielwerte erreichen sie aber fast ähnlich oft.

Reizdarmsyndrom: Diäten wirksamer als Medikamente

29.04.2024 Reizdarmsyndrom Nachrichten

Bei Reizdarmsyndrom scheinen Diäten, wie etwa die FODMAP-arme oder die kohlenhydratreduzierte Ernährung, effektiver als eine medikamentöse Therapie zu sein. Das hat eine Studie aus Schweden ergeben, die die drei Therapieoptionen im direkten Vergleich analysierte.

Akuter Schwindel: Wann lohnt sich eine MRT?

28.04.2024 Schwindel Nachrichten

Akuter Schwindel stellt oft eine diagnostische Herausforderung dar. Wie nützlich dabei eine MRT ist, hat eine Studie aus Finnland untersucht. Immerhin einer von sechs Patienten wurde mit akutem ischämischem Schlaganfall diagnostiziert.

Update Allgemeinmedizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Bildnachweise

Die Leitlinien für Ärztinnen und Ärzte, Facharzttraining Allgemeinmedizin, Mann und Frau schauen auf ein Blutdruckmessgerät/© Miljan Živković / Stock.adobe.com (Symbolbild mit Fotomodellen), Ältere Frau mit Tabletten in der Hand/© LIGHTFIELD STUDIOS / stock.adobe.com (Symbolbild mit Fotomodell), Frau isst Erdbeeren/© kojala / Stock.adobe.com (Symbolbild mit Fotomodell), Eine Frau im MRT/© Maksym Povozniuk / stock.adobe.com (Symbolbild mit Fotomodellen)

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 7/2012

The effects of the Kampo medicine (Japanese herbal medicine) “Daikenchuto” on the surgical inflammatory response following laparoscopic colorectal resection

Double anal canal cancers associated with a long history of perianal Paget’s disease: report of a case

A case of a superficial carcinoma of the esophagus with isolated lymph node metastasis around the abdominal aorta

The effects of the early administration of sivelestat sodium, a selective neutrophil elastase inhibitor, on the postoperative course after radical surgery for esophageal cancer

Safe laparoscopic resection of a gastric gastrointestinal stromal tumor close to the esophagogastric junction

Primary squamous cell carcinoma in the gastric remnant