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Post-discharge surgical site infections after uncomplicated elective colorectal surgery: impact and risk factors. The experience of the VINCat Program

2013; Elsevier BV; Volume: 86; Issue: 2 Linguagem: Inglês

10.1016/j.jhin.2013.11.004

1532-2939

Enrique Limón Cáceres, Evelyn Shaw, Josep M. Badía, Marta Piriz, R Escofet, Francesc Gudiol, Miquel Pujol, D. Castellana, Fernando Barroso-Barcenilla, Gustavo Gabilondo Garcia, R. Antúnez, J. Rebull, M.F. Domenech, Dolors Domènech, D Garcia, Ana Lérida, Luis Gajate Martín, B Oller, Nieves Sopena, Benito Almirante, Carmen Ferrer, R. Pérez, F. Obradors, Gabriel Mestre, Cristina Berbel, P. Serrat, Elisabeth Masgoret Palau, Miquel Iborra, Miguel Servet Zaragoza, Antonio Torres García, Lourdes Grabulosa, F. Pericàs, M.C. Burgas, P. Girbal, Miriam L. González, M.L. Villegas, Laia Ferrer, Miriam Moreno, C. Nicolás, A. Navarro, J. Angás, Mariano Tomás Ros, Àlex Smithson, C. Porrón, M. Nolla, M. Rovira, L.R. Escudero, Marina Clemente Conde, Jordi Espinosa, G Serrate, Luis Falgueras, Isaac Fernandez, A.J. Cruz, V. Ferrer Díaz de Brito, Inés Naranjo Peña, Carlos Agustı́, L. Pagespetit, Marta Andrés Santamaria, Juli Rifà, A. Pinyana, Mercedes Herranz, María José Gil Quílez, Jaime Beltrán, Eduard Sanjurjo, Rosa Maria Vazquez, Jordi Cuquet, Miguel A. Morcillo, Ra- Fael Figueroa Hernández, X. Errando, Esther Kreisler Moreno, Ricardo Ferrer, Ana Casas, Christopher Ramos, I. Roura, Arturo Lopez, Antoni Castro, Ana Martínez Pérez, Joan Espinach, D. Castander, J.C. Paradiñeiro, Montes Claros, Marcelo Farías, Irene Montardit, R. Batlle, A. Cotura, Virginia Pomar, Joaquı́n López-Contreras, Price Cruz, L. Aguilar, J.M Calbet, Sergi Sabaté, Carlos Montilla, Raimon Camps, R.M. Garcia Penche, Maite Coll, Sílvia Caro, D. Ginesta, T. Doménech, Javier P. Gisbert, Emmanuel Redon, José Miguel Lera Tricas, A. Marrón, Montse Brugués, Sandra Santarrufina Martínez, Mireia Garcia Cusco, Oriol Estrada, E. Vidal, J. Roura, Anna Colomer, M. Calsina, M. Vaqué, M. Guillemat, Eva Armengol, B. García Vila, Antonio Torres García,

Colorectal Cancer Surgical Treatments

Surgical site infection (SSI) after colorectal procedures represents a measurable quality indicator of a healthcare system. There is an increasing interest in comparing SSI rates between different hospitals and countries: however, the variability of the data regarding the incidence of SSI makes this comparison difficult. For the purposes of evaluation, data collection must be standardized and must include reliable post-discharge surveillance (PDS).To determine impact and risk factors for PDS SSI after elective colorectal surgery.VINCat is a nosocomial infection surveillance programme in Catalonia, Spain. Between 2007 and 2011, 52 hospitals joined the programme. Hospitals performed active, prospective, standardized surveillance of elective colorectal resection. PDS was implemented by a multimodal approach and was mandatory within the first 30 days after surgery.During the study period, 13,661 elective colorectal procedures were included. SSI was diagnosed in 2826 (20.7%) patients, of whom 22.5% during PDS; of these, 52% required readmission. Patients with PDS SSI were younger (odds ratio: 1.57; 95% confidence interval: 1.29-1.91), predominantly female (1.40; 1.16-1.69), had more frequently undergone endoscopic procedures (1.56; 1.30-1.88) and had more incisional SSI (1.88; 1.54-2.28) than patients with in-hospital SSI.SSI rates in elective colorectal procedures at VINCat hospitals were inside the higher range of those reported by other national programmes. PDS SSI increased the overall rate of SSI, had a significant clinical impact, and accounted for almost a quarter of SSI. Younger age and laparoscopic procedures were the most relevant risk factors. Standardized multimodal PDS should be implemented for hospitals performing surveillance of colorectal surgery.