An interventional nationwide surveillance program lowers postoperative infection rates in elective colorectal surgery: a cohort study (2008-2019)

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• dc.contributor.author Arroyo-García, Nares
• dc.contributor.author Badia, Josep M.
• dc.contributor.author Vázquez, Ana
• dc.contributor.author Pera Roman, Miguel
• dc.contributor.author Parés, David
• dc.contributor.author Limón, Enric
• dc.contributor.author Almendral, Alexander
• dc.contributor.author Piriz, Marta
• dc.contributor.author Cecilia, Díez
• dc.contributor.author Fraccalvieri, Domenico
• dc.contributor.author López Contreras, Joaquín
• dc.contributor.author Pujol, Miquel
• dc.contributor.author Colorectal Surveillance Team
• dc.contributor.author VINCat Program
• dc.date.accessioned 2022-11-10T08:10:58Z
• dc.date.available 2022-11-10T08:10:58Z
• dc.date.issued 2022
• dc.description.abstract Background: colorectal surgery is associated with the highest rate of surgical site infection (SSI). This study analyses the effectiveness of an interventional surveillance program on SSI rates after elective colorectal surgery. Material and methods: cohort study showing temporal trends of SSI rates and Standardized Infection Ratio (SIR) in elective colorectal surgery over a 12-year period. Prospectively collected data of a national SSI surveillance program was analysed and the effect of specific interventions was evaluated. Patient and procedure characteristics, as well as SIR and SSI rates were stratified by risk categories and type of SSI analysed using stepwise multivariate logistic regression models. Results: in a cohort of 42,330 operations, overall cumulative SSI incidence was 16.31%, and organ-space SSI (O/S-SSI) was 8.59%. There was a 61.63% relative decrease in SSI rates (rho = -0.95804). The intervention which achieved the greatest SSI reduction was a bundle of 6 measures. SSI in pre-bundle period was 19.73% vs. 11.10% in post-bundle period (OR 1.969; IC 95% 1.860-2.085; p < 0.0001). O/S-SSI were 9.08% vs. 6.06%, respectively (OR 1.547; IC 95% 1.433-1.670; p < 0.0001). Median length of stay was 7 days, with a significant decrease over the studied period (rho = -0.98414). Mortality of the series was 1.08%, ranging from 0.35% to 2.0%, but a highly significant decrease was observed (rho = -0.67133). Conclusions: Detailed analysis of risk factors and postoperative infection in colorectal surgery allows strategies for reducing SSI incidence to be designed. An interventional surveillance program has been effective in decreasing SIR and SSI rates.
• dc.format.mimetype application/pdf
• dc.identifier.citation Arroyo-Garcia N, Badia JM, Vázquez A, Pera M, Parés D, Limón E, Almendral A, et al. An interventional nationwide surveillance program lowers postoperative infection rates in elective colorectal surgery: a cohort study (2008-2019). Int J Surg. 2022 Jun; 102: 106611. DOI: 10.1016/j.ijsu.2022.106611
• dc.identifier.doi http://dx.doi.org/10.1016/j.ijsu.2022.106611
• dc.identifier.issn 1743-9159
• dc.identifier.uri http://hdl.handle.net/10230/54784
• dc.language.iso eng
• dc.publisher Elsevier
• dc.rights 1743-9191/© 2022. Arroyo-Garcia N, Badia JM, Vázquez A, Pera M, Parés D, Limón E, Almendral A, et al. The Authors. Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
• dc.subject.keyword Adverse effects
• dc.subject.keyword Cohort studies
• dc.subject.keyword Colorectal surgery
• dc.subject.keyword Prevention & control
• dc.subject.keyword Standardized infection ratio
• dc.subject.keyword Surgical site infection
• dc.subject.keyword Surgical wound infection
• dc.title An interventional nationwide surveillance program lowers postoperative infection rates in elective colorectal surgery: a cohort study (2008-2019)
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion