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Feature

High Incidence of surgical site infections in Europe presents a risk to patients, and an economic burden

Urgent call to action Posted on: 21 Jan 05
High Incidence of surgical site infections in Europe presents a risk to patients, and an economic burden

Summary

The increasing incidence of surgical site infections (SSIs) among hospital patients in Europe has led to a call to action for cost-effective preventative measures to be put in place by hospitals, to help minimize the risk of infection and the cost impact on healthcare systems. A consensus paper, developed by a number of leading healthcare experts in Europe and published today in the International Wound Journal, indicates the scale of the problem and the estimated financial impact on the health

High incidence of surgical site infections in Europe presents a risk to patients, and an economic burden


Urgent call to implement cost-effective, preventative measures in hospital


 


15 December 2004, London – The increasing incidence of surgical site infections (SSIs) among hospital patients in Europe has led to a call to action for cost-effective preventative measures to be put in place by hospitals, to help minimize the risk of infection and the cost impact on healthcare systems.  A consensus paper, developed by a number of leading healthcare experts in Europe and published today in the International Wound Journal, indicates the scale of the problem and the estimated financial impact on the health economy. 


 


The current absence of a single recognized framework for monitoring and reporting SSIs, has meant that there has been no previous assessment of their incidence at a pan-European level, although a number of national prevalence studies have been conducted.1–5 


 


The consensus paper follows from a review of the key studies, to provide a clearer picture of the extent of the problem in Europe and the associated cost burden.


 


There are an estimated 30 million surgical procedures conducted in Europe each year, and the possible range for the number of cases of SSIs per year falls between 450,000 and 600,000, or between 1.5 and 20 percent depending on the type of surgical procedure and wound classification.6 


 


The current drive to shorten post-operative hospital stay and increase the proportion of day surgery has resulted in an estimated 12–84 percent of SSIs being detected after discharge from hospital,7,9–13 leading to a


 


significant proportion of patients requiring re-admission and treatment. Patients who develop an SSI are more likely to have an extended length of stay in hospital, on average up to 10 days7,8,14–16 and could be


 


costing European health care systems between 1.47–19.1 billion Euros each year.6


 


Commenting on the consensus paper, lead author Professor David Leaper, Visiting Professor of Surgery at Cardiff University and Emeritus Professor of Surgery at the University of Newcastle, said: ‘SSIs represent a much wider issue than existing data would suggest and are often masked through lack of awareness, inadequate resources, and shorter hospital stays.  Increased infectious complications can result in reduced quality of life for patients and may require additional use of medical and therapeutic resources, including antibiotics with all their attendant complications of resistance, toxicity, bacterial emergence, and allergy.  All of these factors have a significant impact on patients and hospitals, and represent an economic burden for healthcare systems.  It is crucial that guidelines are established in Europe for monitoring, detecting, and recording SSIs, to gain a clearer understanding of their prevalence and the steps that need to be taken to minimize the risk to patients.’


 


SSIs contribute significantly to the morbidity and mortality associated with surgical procedures,7,8,17–21 and continue to be one


 


of the most serious complications that can occur in surgical patients.7,8,17–20  SSIs


 


account for approximately 15–20 percent of all healthcare associated infections and data suggests that Staphylococcus aureus is the most common causative organism, accounting for some 30–40 percent of cases.6 


 


Dr Jacqui Reilly, Consultant Epidemiologist, Health Protection Scotland, said: ‘Surgical site infection in the post-operative period can be very costly.  The cost is threefold: the cost to the hospital, the community services, and the patient.  Estimates of the extra cost attributable to these infections in hospital have been reported and are considerable. However, the impact of an SSI to the individual patient is important in terms of the pain, suffering, longer lengths of stay in hospital and slow return to work, and social activities.  As such, it is important that healthcare professionals do all they can to prevent these infections.’


 


 


-Ends-


 


 


For more information contact







Surinder Maan


Tel: +44 (0)20 7785 1874


Email: surinder.maan@eurorscg.com


 


 


 


 


 


References


 


1.      Emmerson AM, Enstone JE, Griffin M, Kelsey MC, Smyth ET. The Second National Prevalence Survey of infection in hospitals – overview of the results. J Hosp Infect 1996;32:175–90.


2.      Vaque´ J, Rossello´ J, Arribas JL and the EPINE Working Group. Prevalence of nosocomial infections in Spain: EPINE study 1990–1997. J Hosp Infect 1999;43 (Suppl.):S105–11.


3.      The French Prevalence Survey Study Group. Prevalence of nosocomial infections in France: results of the nationwide survey in 1996. J Hosp Infect 2000;46:186–93.


4.      Geubbels EL, Mintjes-de Groot AJ, van den Berg JM, de Boer AS. An operating surveillance system of surgical-site infections in The Netherlands: results of the PREZIES national surveillance network. Infect Control Hosp Epidemiol 2000;21:311–8.


5.      Ruden H, Gastmeier P, Daschner FD, Schumacher M. Nosocomial and community-acquired infections in Germany. Summary of the results of the First National Prevalence Study (NIDEP). Infection 1997;25:199–202.


6.      Leaper DJ, Van Goor H, Reilly J et al. Surgical site infection – a European Perspective of incidence and economic burden. International Wound Journal 2004:1:1–26 http://www.blackwell-synergy.com/rd.asp?code=IWJ&goto=journal


7.      Coello R, Glenister H, Fereres J, Bartlett C, Leigh D, Sedgwick J, Cooke EM. The cost of infection in surgical patients: a case-control study. J Hosp Infect 1993;25:239–50.


8.      Plowman R, Graves N, Griffin MA, Roberts JA, Swan AV, Cookson B, Taylor L. The rate and cost of hospital-acquired infections occurring in patients admitted to selected specialties of a district general hospital in England and the national burden imposed. J Hosp Infect 2001;47:198–209.


9.      Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol 1999;20:250–78.


10.  Couto RC, Pedrosa TM, Nogueira JM, Gomes DL, Neto MF, Rezende NA. Post-discharge surveillance and infection rates in obstetric patients. Int J Gynaecol Obstet 1998;61:227–31.


11.  Byrne DJ, Lynch W, Napier A, Davey P, Malek M, Cuschieri A. Wound infection rates: the importance of definition and post-discharge wound surveillance. J Hosp Infect 1994;26:37–43.


12.  Taylor S, Pearce P, McKenzie M, Taylor GD. Wound infection in total joint arthroplasty: effect of extended wound surveillance on wound infection rates. Can J Surg 1994;37:217–20.


13.  Noy DL, Creedy DK. Postdischarge surveillance of surgical site infections: a multi-method approach to data collection. Am J Infect Control 2002;30:417–24.


14.  Ronveaux O, Mertens R, Dupont Y. Surgical wound infection surveillance: results from the Belgian hospital network. Acta Chir Belg 1996;96:3–10.


15.  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;20:725–30.


16.  Rios J, Murillo C, Carrasco G, Humet C. Increase in costs attributable to surgical infection after appendicectomy and colectomy. Gac Sanit 2003;17:218–25.


17.  Altemeier WA. Surgical infections: incisional wounds. In: Bennett JV, Brachman PS, editors. Hospital infections. Boston: Little Brown and Company 1979:287–307.


18.  Cruse PJ, Foord R. The epidemiology of wound infection. A 10-year prospective study of 62,939 wounds. Surg Clin North Am 1980;60:27–40.


19.  Haley RW, Schaberg DR, Crossley KB, Von Allmen SD, McGowan JE Jr. Extra charges and prolongation of stay attributable to nosocomial infections: a prospective interhospital comparison. Am J Med 1981;70:51–8.


20.  Mayon-White RT, Ducel G, Kereselidze T, Tikomirov E. An international survey of the prevalence of hospital-acquired infection. J Hosp Infect 1988;11 (Suppl. A):43–8.


21.  Astagneau P, Rioux C, Golliot F, Brucker G for the INCISO Network Study Group. Morbidity and mortality associated with surgical site infections: results from the 1997–1999 INCISO surveillance. J Hosp Infect 2001;48:267–74.


 

Wound Healing Research Unit

Last updated on: 27/08/2010 11:40:18

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