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

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

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

15 December 2004, – The increasing incidence of surgical site infections (SSIs) among hospital patients in 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 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 days^7,8,14–16 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-

References

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