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The impact of surgical-site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs.

Publication ,  Journal Article
Kirkland, KB; Briggs, JP; Trivette, SL; Wilkinson, WE; Sexton, DJ
Published in: Infect Control Hosp Epidemiol
November 1999

OBJECTIVE: To determine mortality, morbidity, and costs attributable to surgical-site infections (SSIs) in the 1990s. DESIGN: A matched follow-up study of a cohort of patients with SSI, matched one-to-one with patients without SSI. SETTING: A 415-bed community hospital. STUDY POPULATION: 255 pairs of patients with and without SSI were matched on age, procedure, National Nosocomial Infection Surveillance System risk index, date of surgery, and surgeon. OUTCOME MEASURES: Mortality, excess length of hospitalization, and extra direct costs attributable to SSI; relative risk for intensive care unit (ICU) admission and for readmission to the hospital. RESULTS: Of the 255 pairs, 20 infected patients (7.8%) and 9 uninfected patients (3.5%) died during the postoperative hospitalization (relative risk [RR], 2.2; 95% confidence interval [CI95], 1.1-4.5). Seventy-four infected patients (29%) and 46 uninfected patients (18%) required ICU admission (RR, 1.6; CI95, 1.3-2.0). The median length of hospitalization was 11 days for infected patients and 6 days for uninfected patients. The extra hospital stay attributable to SSI was 6.5 days (CI95, 5-8 days). The median direct costs of hospitalization were $7,531 for infected patients and $3,844 for uninfected patients. The excess direct costs attributable to SSI were $3,089 (CI95, $2,139-$4,163). Among the 229 pairs who survived the initial hospitalization, 94 infected patients (41%) and 17 uninfected patients (7%) required readmission to the hospital within 30 days of discharge (RR, 5.5; CI95, 4.0-7.7). When the second hospitalization was included, the total excess hospitalization and direct costs attributable to SSI were 12 days and $5,038, respectively. CONCLUSIONS: In the 1990s, patients who develop SSI have longer and costlier hospitalizations than patients who do not develop such infections. They are twice as likely to die, 60% more likely to spend time in an ICU, and more than five times more likely to be readmitted to the hospital. Programs that reduce the incidence of SSI can substantially decrease morbidity and mortality and reduce the economic burden for patients and hospitals.

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Published In

Infect Control Hosp Epidemiol

DOI

ISSN

0899-823X

Publication Date

November 1999

Volume

20

Issue

11

Start / End Page

725 / 730

Location

United States

Related Subject Headings

  • Surgical Wound Infection
  • Patient Readmission
  • North Carolina
  • Middle Aged
  • Length of Stay
  • Humans
  • Hospitals, Community
  • Hospital Costs
  • Health Care Costs
  • Follow-Up Studies
 

Citation

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Kirkland, K. B., Briggs, J. P., Trivette, S. L., Wilkinson, W. E., & Sexton, D. J. (1999). The impact of surgical-site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs. Infect Control Hosp Epidemiol, 20(11), 725–730. https://doi.org/10.1086/501572
Kirkland, K. B., J. P. Briggs, S. L. Trivette, W. E. Wilkinson, and D. J. Sexton. “The impact of surgical-site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs.Infect Control Hosp Epidemiol 20, no. 11 (November 1999): 725–30. https://doi.org/10.1086/501572.
Kirkland KB, Briggs JP, Trivette SL, Wilkinson WE, Sexton DJ. The impact of surgical-site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs. Infect Control Hosp Epidemiol. 1999 Nov;20(11):725–30.
Kirkland, K. B., et al. “The impact of surgical-site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs.Infect Control Hosp Epidemiol, vol. 20, no. 11, Nov. 1999, pp. 725–30. Pubmed, doi:10.1086/501572.
Kirkland KB, Briggs JP, Trivette SL, Wilkinson WE, Sexton DJ. The impact of surgical-site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs. Infect Control Hosp Epidemiol. 1999 Nov;20(11):725–730.
Journal cover image

Published In

Infect Control Hosp Epidemiol

DOI

ISSN

0899-823X

Publication Date

November 1999

Volume

20

Issue

11

Start / End Page

725 / 730

Location

United States

Related Subject Headings

  • Surgical Wound Infection
  • Patient Readmission
  • North Carolina
  • Middle Aged
  • Length of Stay
  • Humans
  • Hospitals, Community
  • Hospital Costs
  • Health Care Costs
  • Follow-Up Studies