Five-Year Analysis of Surgical Site Infections in Three Orthopaedics and Trauma Wards under HAI-Net from the South of Poland in 2014–2018 Considering the Standardized Infection Ratio
Abstract
:1. Background
2. Material and Methods
3. Results
4. Discussion
5. Limitations of the Study
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Data Type | H1 | H2 | H3 | Total |
---|---|---|---|---|
Patients’ age | ||||
Mean age (years) | 63.4 | 59.0 | 64.2 | 62.5 |
Patients’ sex | ||||
Men n (%) | 1614 (43.3) | 658 (43.9) | 448 (43.4) | 2720 (43.5) |
Women n (%) | 2115 (56.7) | 840 (56.1) | 585 (56.6) | 3540 (56.5) |
Total n (%) | 3729 (100.0) | 1498 (100.0) | 1033 (100.0) | 6260 (100.0) |
Type of SSI | ||||
SSI-S n (%) | 0 (0.0) | 5 (13.9) | 10 (28.6) | 15 (13.5) |
SSI-D n (%) | 40 (100.0) | 26 (72.2) | 24 (68.6) | 90 (81.1) |
SSI-O n (%) | 0 (0.0) | 5 (13.9) | 1 (2.9) | 6 (5.4) |
Total SSI n (%) | 40 (100.0) | 36 (100.0) | 35 (100.0) | 111 (100.0) |
Procedure type | ||||
CR n (%) | 727 (19.5) | 330 (22.0) | 331 (32.0) | 1388 (22.2) |
FX n (%) | 1354 (36.3) | 675 (45.1) | 103 (10.0) | 2132 (34.1) |
HPRO n (%) | 1228 (32.9) | 493 (32.9) | 461 (44.6) | 2182 (34.9) |
KPRO n (%) | 420 (11.3) | 0 (0.0) | 138 (13.4) | 558 (8.9) |
Total n (%) | 3729 (100.0) | 1498 (100.0) | 1033 (100.0) | 6260 (100.0) |
Operation time—median | ||||
CR | 50.0 | 35.0 | 90.0 | 55.5 |
FX | 70.0 | 80.0 | 90.0 | 75.9 |
HPRO | 85.0 | 90.0 | 90.0 | 88.1 |
KPRO | 105.0 | 0.0 | 90.0 | 99.0 |
Total | 75.0 | 80.0 | 90.0 | 77.6 |
Operation Type | HPRO | KPRO | FX | CR | Total |
---|---|---|---|---|---|
Number of operations | 2182 | 558 | 2133 | 1388 | 6261 |
Number of SSI | 46 | 11 | 40 | 14 | 111 |
Incidence (%) | 2.1 | 2.0 | 1.9 | 1.0 | 1.8 |
Waiting time for surgery in the ward (days) | |||||
mean; SD; (95% CI) | 4.3; 8.5; (3.9–4.7) | 4.1; 4.9; (3.6–4.5) | 2.6; 5.1; (2.4–2.8) | 3.5; 4.7; (3.3–3.8) | 3.1; 4.2; (2.9–3.1) |
Person–days of hospitalisation in the ward (days) | |||||
mean; SD; (95% CI) | 12.5; 10.7; (11.9–13.2) | 12.9; 9.5; (11.9–13.8) | 9.1; 13.8; (8.3–9.7) | 6.1; 6.7; (5.6–6.6) | 10.1; 11.8; (9.7–10.5) |
Number of days from surgery to the detection of SSI | |||||
mean; SD; (95% CI) | 36.1; 69.8; (15.9–56.1) | 52.3; 85.3; (8.5–109.6) | 68.9; 67.5; (47.3–90.5) | 35.5; 20.6; (23.6–47.5) | 48.1; 66.7 (45.6–69.4) |
Patient age (years) | |||||
mean; SD; (95% CI) | 70.9; 11.8 (70.4–71.3) | 69.1; 8.2; (68.4–69.7) | 57.8; 21.7; (56.9–58.8) | 53.6; 26.2; (52.2–54.9) | 62.8; 17.7; (62.4–63.1) |
Sex | |||||
Sex ratio (M:F) | 0.6 | 0.4 | 0.7 | 1.1 | 0.8 |
Duration of surgery (minutes) | |||||
50 (percentile) | 90 | 103 | 70 | 55 | |
75 (percentile) | 105 | 120 | 90 | 75 | |
Diagnosis of SSI: before discharge vs. after discharge | |||||
Before discharge n (%) | 24 (52.2) | 7 (63.6) | 23 (57.5) | 8 (57.1) | 63 (54.3) |
After discharge n (%) | 22 (47.8) | 4 (36.4) | 17 (42.5) | 6 (42.9) | 53 (45.7) |
Total n (%) | 46 (100.0) | 11 (100.0) | 40 (100.0) | 14 (100.0) | 116 (100.0) |
Type of SSI | |||||
SSI-S | 0 (0.0) | 1 (10.0) | 10 (25.0) | 5 (35,7) | 16 (14,4) |
SSI-D | 46 (100.0) | 10 (90.0) | 26 (65.0) | 9 (64,2) | 91 (81,9) |
SSI-O | 0 (0.0) | 0 (0.0) | 4 (10.0) | 0 (0.0) | 4 (3,6) |
46 (100.0) | 11 (100.0) | 40 (100.0) | 14 (100.0) | 111 (100.0) |
Hospital Type | Number of Surgeries | Number of SSIs | Incidence (%) | Incidence (%) ECDC | Expected Number of SSIs | SIR * SSI | SD; (95%CI) |
---|---|---|---|---|---|---|---|
HPRO—Hip Prosthesis | |||||||
Hospital (H1) | 1228 | 16 | 1.3 | 1.1 | 15 | 1.1 | 1.2; (0.2–5.2) |
Hospital (H2) | 493 | 18 | 3.7 | 1.1 | 5 | 3.5 | |
Hospital (H3) | 2182 | 46 | 2.1 | 1.1 | 24 | 1.9 | |
KPRO—Knee Prosthesis | |||||||
Hospital (H1) | 420 | 9 | 2.1 | 0.6 | 3 | 3.0 | 0.4; (0.2–6.5) |
Hospital (H3) | 138 | 2 | 1.4 | 0.6 | 1 | 2.4 | |
FX—Open Reduction of Fracture | |||||||
Hospital (H1) | 1354 | 9 | 0.7 | 2.1 | 21 | 0.4 | 4.1; (0.3–13.3) |
Hospital (H2) | 675 | 14 | 2.1 | 2.1 | 9 | 1.5 | |
Hospital (H3) | 103 | 17 | 16.5 | 2.1 | 2 | 7.9 |
HPRO | KPRO | FX | CR | Total n (%) | |
---|---|---|---|---|---|
No etiological agent n (%) | 1 (2.2) | 2 (18.2) | 3 (7.5) | 0 (0.0) | 6 (5.4) |
Not detected/not collected | 1 (2.2) | 2 (18.2) | 3 (7.5) | 0 (0.0) | 6 (5.4) |
Gram-positive cocci n (%) | 16 (34.8) | 7 (63.6) | 24 (60.0) | 7 (49.9) | 54 (48.6) |
Staphylococcus aureus | 4 (8.7) | 3 (27.3) | 17 (42.5) | 5 (35.7) | 29 (26.1) |
Coagulase-negative staphylococci | 8 (17.4) | 4 (36.4) | 3 (7.5) | 1 (7.1) | 16 (14.4) |
Enterococcus faecalis | 4 (8.7) | 0 (0.0) | 2 (5.0) | 0 (0.0) | 6 (5.4) |
Other Gram-positive cocci | 0 (0.0) | 0 (0.0) | 2 (5.0) | 1 (7.1) | 3 (2.7) |
Enterobacteriaceae n (%) | 18 (39.1) | 1 (9.1) | 7 (17.5) | 4 (28.5) | 30 (27.0) |
Escherichia coli | 5 (10.9) | 0 (0.0) | 2 (5.0) | 2 (14.3) | 9 (8.1) |
Klebsiella pneumoniae | 8 (17.4) | 1 (9.1) | 3 (7.5) | 0 (0.0) | 12 (10.8) |
Other Enterobacteriaceae | 5 (10.9) | 0 (0.0) | 2 (5.0) | 2 (14.3) | 9 (8.1) |
Non-fermenting Gram-negative bacteria | 11 (23.9) | 1 (9.1) | 4 (10.0) | 3 (21.4) | 19 (17.1) |
Acinetobacter baumannii | 3 (6.5) | 1 (9.1) | 0 (0.0) | 1 (7.1) | 5 (4.5) |
Proteus mirabilis | 5 (10.9) | 0 (0.0) | 4 (10.0) | 2 (14.3) | 11 (9.9) |
Other non-fermenting Gram-negative bacteria | 3 (6.5) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 3 (2.7) |
Others | 0 (0.0) | 0 (0.0) | 2 (5.0) | 0 (0.0) | 2 (1.8) |
Clostridium spp. | 0 (0.0) | 0 (0.0) | 1 (2.5) | 0 (0.0) | 1 (0.9) |
Corynebacterium spp. | 0 (0.0) | 0 (0.0) | 1 (2.5) | 0 (0.0) | 1 (0.9) |
Total n (%) | 46 (100.0) | 11 (100.0) | 40 (100.0) | 14 (100.0) | 111 (100.0) |
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Wałaszek, M.Z.; Słowik, R.; Domański, A.; Wałaszek, M.J.; Różańska, A.; Kołpa, M. Five-Year Analysis of Surgical Site Infections in Three Orthopaedics and Trauma Wards under HAI-Net from the South of Poland in 2014–2018 Considering the Standardized Infection Ratio. Medicina 2022, 58, 682. https://doi.org/10.3390/medicina58050682
Wałaszek MZ, Słowik R, Domański A, Wałaszek MJ, Różańska A, Kołpa M. Five-Year Analysis of Surgical Site Infections in Three Orthopaedics and Trauma Wards under HAI-Net from the South of Poland in 2014–2018 Considering the Standardized Infection Ratio. Medicina. 2022; 58(5):682. https://doi.org/10.3390/medicina58050682
Chicago/Turabian StyleWałaszek, Marta Zofia, Roża Słowik, Adam Domański, Michał Jan Wałaszek, Anna Różańska, and Małgorzata Kołpa. 2022. "Five-Year Analysis of Surgical Site Infections in Three Orthopaedics and Trauma Wards under HAI-Net from the South of Poland in 2014–2018 Considering the Standardized Infection Ratio" Medicina 58, no. 5: 682. https://doi.org/10.3390/medicina58050682