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Economic Burden of Surgical Site Infections at a European University Hospital

Published online by Cambridge University Press:  02 January 2015

Walter P. Weber
Affiliation:
Department of General Surgery, University Hospital of Basel, Switzerland
Marcel Zwahlen
Affiliation:
Research Support Unit, Institute of Social and Preventive Medicine, University of Bern, Switzerland
Stefan Reck
Affiliation:
Department of General Surgery, University Hospital of Basel, Switzerland
Chantal Feder-Mengus
Affiliation:
Department of General Surgery, University Hospital of Basel, Switzerland
Heidi Misteli
Affiliation:
Department of General Surgery, University Hospital of Basel, Switzerland
Rachel Rosenthal
Affiliation:
Department of General Surgery, University Hospital of Basel, Switzerland
Daniel Brandenberger
Affiliation:
Department of General Surgery, University Hospital of Basel, Switzerland
Daniel Oertli
Affiliation:
Department of General Surgery, University Hospital of Basel, Switzerland
Andreas F. Widmer
Affiliation:
Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Basel, Switzerland
Walter R. Marti*
Affiliation:
Department of General Surgery, University Hospital of Basel, Switzerland
*
Department of General Surgery, University Hospital of Basel, CH-4031 Basel, Switzerland (wrmarti@uhbs.ch)

Abstract

Objective.

To quantify the economic burden of in-hospital surgical site infections (SSIs) at a European university hospital.

Design.

Matched case-control study nested in a prospective observational cohort study.

Setting.

Basel University Hospital in Switzerland, where an average of 28,000 surgical procedures are performed per year.

Methods.

All in-hospital occurrences of SSI associated with surgeries performed between January 1, 2000, and December 31, 2001, by the visceral, vascular, and traumatology divisions at Basel University Hospital were prospectively recorded. Each case patient was matched to a control patient by age, procedure code, and National Nosocomial Infection Surveillance System risk index. The case-control pairs were analyzed for differences in cost of hospital care and in provision of specialized care.

Results.

A total of 6,283 procedures were performed:187 SSIs were detected in inpatients, 168 of whom were successfully matched with a control patient. For case patients, the mean additional hospital cost was SwF19,638 (95% confidence interval [CI], SwF8,492–SwF30,784); the mean additional postoperative length of hospital stay was 16.8 days (95% CI, 13–20.6 days); and the mean additional in-hospital duration of antibiotic therapy was 7.4 days (95% CI, 5.1–9.6 days). Differences were primarily attributable to organ space SSIs (n = 76).

Conclusions.

Ina European university hospital setting, SSIs are costly and constitute a heavy and potentially preventable burden on both patients and healthcare providers.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2008

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