An interventional nationwide surveillance program lowers postoperative infection rates in elective colorectal surgery. A cohort study (2008–2019)
Author
ARROYO GARCÍA, NARES
Vázquez, Ana
Pera, Miguel
Parés, David
Limón, Enric
Almendral, Alexander
Piriz, Marta
Díez, Cecilia
Fraccalvieri, Domenico
López-Contreras, Joaquín
Pujol, Miquel
Members of the VINCat Colorectal Surveillance Team
VINCat Program
Publication date
2022ISSN
1743-9191
Abstract
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.
Document Type
Article
Document version
Published version
Language
English
Subject (CDU)
61 - Medical sciences
617 - Surgery. Orthopaedics. Ophthalmology
Keywords
Infecció del lloc quirúrgic
Ratio d'infecció estandarditzat
Infecció de ferides quirúrgiques
Prevenció i control
Estudis de cohorts
Cirurgia colorrectal
Efectes adversos
Prevenció i control
Infección del sitio quirúrgico
Proporción de infección estandarizada
Infección de la herida quirúrgica
Prevención y control
Estudios de cohortes
Cirugía colorrectal
Efectos adversos
Prevención y control
Surgical site infection
Standardized infection ratio
Surgical wound infection
Prevention & control
Cohort studies
Colorectal surgery
Adverse effects
Prevention & control
Pages
11
Publisher
Elsevier
Collection
102
Is part of
International Journal of Surgery
Citation
Arroyo García, Nares; Badia, Josep M; Vázquez, Ana [et al.]. An interventional nationwide surveillance program lowers postoperative infection rates in elective colorectal surgery. A cohort study (2008–2019). International Journal of Surgery, 2022, 102, 106611. Disponible en: <https://www.sciencedirect.com/science/article/pii/S1743919122003880?via%3Dihub<. Fecha de acceso: 6 jul. 2022. DOI: 10.1016/j.ijsu.2022.106611
Link to the related item
This item appears in the following Collection(s)
- Ciències de la Salut [725]
Rights
This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Except where otherwise noted, this item's license is described as https://creativecommons.org/licenses/by-nc-nd/4.0/