TY - JOUR
T1 - Risk of surgical site infection in older patients in a cohort survey
T2 - Targets for quality improvement in antibiotic prophylaxis
AU - Agodi, Antonella
AU - Quattrocchi, Annalisa
AU - Barchitta, Martina
AU - Adornetto, Veronica
AU - Cocuzza, Aldo
AU - Latino, Rosalia
AU - Destri, Giovanni Li
AU - Cataldo, Antonio Di
PY - 2015/3
Y1 - 2015/3
N2 - The aims of the present study were to: (1) assess surgical site infection (SSI) incidence in a cohort of surgical patients and (2) estimate the compliance with national guidelines for perioperative antibiotic prophylaxis (PAP). SSIs, among the most common health care-associated infections, are an important target for surveillance and an official priority in several European countries. SSI commonly complicates surgical procedures in older people and is associated with substantial attributable mortality and costs. The implementation of PAP guidelines is difficult among surgeons, and failure to comply with the standard of care has been widely reported. A 12-month prospective survey was performed in accordance with the methods, protocols, and definitions of the Hospital in Europe Link for Infection Control through Surveillance (HELICS) protocol. The compliance of the current PAP practices with the published national guidelines was assessed. A total of 249 patients were enrolled. The cumulative SSI incidence was 3.2 per 100 operative procedures. Cumulative compliance for PAP was 12.4%. Overall, only infection risk index ≥1 was confirmed as a significant risk factor for SSI (odds ratio, 6.65; 95% confidence interval, 1.04-42.59; P= 0.045).When only older patients (age >65 years) were considered, no significant risk factors for SSI were identified. Our study indicates an overall inadequate compliance with PAP recommendations, thus highlighting the need to develop multimodal and targeted intervention programs to improve compliance with PAP guidelines.
AB - The aims of the present study were to: (1) assess surgical site infection (SSI) incidence in a cohort of surgical patients and (2) estimate the compliance with national guidelines for perioperative antibiotic prophylaxis (PAP). SSIs, among the most common health care-associated infections, are an important target for surveillance and an official priority in several European countries. SSI commonly complicates surgical procedures in older people and is associated with substantial attributable mortality and costs. The implementation of PAP guidelines is difficult among surgeons, and failure to comply with the standard of care has been widely reported. A 12-month prospective survey was performed in accordance with the methods, protocols, and definitions of the Hospital in Europe Link for Infection Control through Surveillance (HELICS) protocol. The compliance of the current PAP practices with the published national guidelines was assessed. A total of 249 patients were enrolled. The cumulative SSI incidence was 3.2 per 100 operative procedures. Cumulative compliance for PAP was 12.4%. Overall, only infection risk index ≥1 was confirmed as a significant risk factor for SSI (odds ratio, 6.65; 95% confidence interval, 1.04-42.59; P= 0.045).When only older patients (age >65 years) were considered, no significant risk factors for SSI were identified. Our study indicates an overall inadequate compliance with PAP recommendations, thus highlighting the need to develop multimodal and targeted intervention programs to improve compliance with PAP guidelines.
KW - Cohort study
KW - Older patients
KW - Surgery
KW - Surgical site infection
KW - Surveillance
UR - http://www.scopus.com/inward/record.url?scp=84974539671&partnerID=8YFLogxK
U2 - 10.9738/INTSURG-D-14-00042.1
DO - 10.9738/INTSURG-D-14-00042.1
M3 - Review article
C2 - 25785330
AN - SCOPUS:84974539671
SN - 0020-8868
VL - 100
SP - 473
EP - 479
JO - International Surgery
JF - International Surgery
IS - 3
ER -