TROILLET N, PETIGNAT C, EISENRING MC, FRANCIOLI P; Interscience Conference on Antimicrobial Agents and Chemotherapy (41st : 2001 : Chicago, Ill.).

Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2001 Dec 16-19; 41: abstract no. K-1456.

Central Inst. of Valais Hospitals, Sion, Switzerland

BACKGROUND: The National Nosocomial Infection Surveillance (NNIS) risk index is commonly used for adjustment when comparing SSI rates between hospitals (hosp). METHODS: 4869 patients (M/F ratio=53/47; mean age=53.5 years) from 6 hosp. in Western Switzerland were included in a surveillance program for SSI in digestive surgery. RESULTS: Interventions (interv.) were: herniorrhaphy 20%, cholecystectomy 20%, appendectomy 16%, colon surgery 15%, gastric surgery 10%, laparotomy 5%, liver or pancreas 4%, other interv. 10%. 14% included >1 procedure, 27% were emergencies, 33% were performed with a laparoscope. SSI occured in 432 patients (8.9%), 34% post-discharge. Infection rates varied significantly between interv. categories (range: herniorraphy=2% - colon=20%) and hosp. (range: 5.7-11.9%). Overall, risk factors for SSI in univariate analysis were: an old age, a high contamination class or ASA score, a long prior hospital stay, and having undergone a long-lasting interv. (>T), an emergency procedure, >1 procedure during the same interv., or a re-interv. for a non-infectious complication. The use of a laparoscope was protective. Logistic regression identified 5 independent risk factors, 3 of which constitute the NNIS risk index (*), and 1 protective factor: contamination class* (OR=1.6; CI[95]=1.5-1.8), ASA score* (1.4; 1.2-1.6), duration>T* (1.9; 1.5-2.4), >1 procedure (1.5; 1.2-1.9), re-interv. (3.0; 1.9-4.6), laparoscope (0.4; 0.3-0.5). ORs determined for individual hosp. as compared to the others varied when logistic regression models included the last 3 factors in addition to the NNIS risk index. Changes ranged from -16 to +8% for herniorrhaphy; -4 to +12% for cholecystectomy; -25 to +39% for appendectomy; and -6 to +8% for colon surgery. CONCLUSION: Factors not included in the NNIS risk index should be considered when establishing interhosp. comparisons in SSI rates.

Publication Types:

• Meeting Abstracts

Keywords:

• Communicable Diseases
• Cross Infection
• Hospitals
• Humans
• Logistic Models
• Risk Adjustment
• Risk Factors
• Switzerland
• epidemiology

Other ID:

• GWAIDS0030217

UI: 102269849

From Meeting Abstracts