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Impact of Postdischarge Surveillance on Surgical Site Infection Rates for Several Surgical Procedures Results From the Nosocomial Surveillance Network in The Netherlands

Published online by Cambridge University Press:  21 June 2016

Judith Manniën ,
Jan C. Wille ,
Ruud L. M. M. Snoeren  and
Susan van den Hof
Judith Manniën*
Affiliation:
National Institute for Public Health and the Environment, Bilthoven, The Netherlands
Jan C. Wille
Affiliation:
Dutch Institute for Healthcare Improvement, CBO, Utrecht, The Netherlands
Ruud L. M. M. Snoeren
Affiliation:
St. Elisabeth Hospital, Tilburg, The Netherlands
Susan van den Hof
Affiliation:
National Institute for Public Health and the Environment, Bilthoven, The Netherlands
*
National Institute for Public Health and the Environment, PO Box 1, Bilthoven, The Netherlands, (Judith.Mannien@rivm.nl)
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Abstract

Objective.

To compare the number of surgical site infections (SSIs) registered after hospital discharge with respect to various surgical procedures and to identify the procedures for which postdischarge surveillance (PDS) is most important.

Design.

Prospective SSI surveillance with voluntary PDS. Recommended methods for PDS in the Dutch national nosocomial surveillance network are addition of a special registration card to the outpatient medical record, on which the surgeon notes clinical symptoms and whether a patient developed an SSI according to the definitions; an alternative method is examination of the outpatient medical record.

Setting.

Hospitals participating in the Dutch national nosocomial surveillance network between 1996 and 2004.

Results.

We collected data on 131,798 surgical procedures performed in 64 of the 98 Dutch hospitals. PDS was performed according to one of the recommended methods for 31,134 operations (24%) and according to another active method for 32,589 operations (25%), and passive PDS was performed for 68,075 operations (52%). Relatively more SSIs were recorded after discharge for cases in which PDS was performed according to a recommended method (43%), compared with cases in which another active PDS method was used (30%) and cases in which passive PDS was used (25%). The highest rate of SSI after discharge was found for appendectomy (79% of operations), followed by knee prosthesis surgery (64%), mastectomy (61%), femoropopliteal or femorotibial bypass (53%), and abdominal hysterectomy (53%).

Conclusions.

For certain surgical procedures, most SSIs develop after discharge. SSI rates will be underestimated if no PDS is performed. We believe we have found a feasible and sensitive method for PDS that, if patients routinely return to the hospital for a postdischarge follow-up visit, might be suitable for use internationally.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 27 , Issue 8 , August 2006 , pp. 809 - 816
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2006

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