An interventional nationwide surveillance program lowers postoperative infection rates in elective colorectal surgery. A cohort study (2008–2019)

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...

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Autores: ARROYO GARCÍA, NARES, Badia, Josep M, Vázquez, Ana, Pera, Miguel, Parés, David, Limón, Enric, Almendral, Alexander, Piriz, Marta, Díez, Cecilia, Fraccalvieri, Domenico, López-Contreras, Joaquín, Pujol, Miquel, Members of the VINCat Colorectal Surveillance Team, VINCat Program
Tipo de recurso: artículo
Fecha de publicación:2022
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:20.500.12328/3355
Acceso en línea:http://hdl.handle.net/20.500.12328/3355
https://dx.doi.org/10.1016/j.ijsu.2022.106611
Access Level:acceso abierto
Palabra clave:Infecció del lloc quirúrgic
Ratio d'infecció estandarditzat
Infecció de ferides quirúrgiques
Prevenció i control
Estudis de cohorts
Cirurgia colorrectal
Efectes adversos
Infección del sitio quirúrgico
Proporción de infección estandarizada
Infección de la herida quirúrgica
Prevención y control
Estudios de cohortes
Cirugía colorrectal
Efectos adversos
Surgical site infection
Standardized infection ratio
Surgical wound infection
Prevention & control
Cohort studies
Colorectal surgery
Adverse effects
61
617
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spelling An interventional nationwide surveillance program lowers postoperative infection rates in elective colorectal surgery. A cohort study (2008–2019)ARROYO GARCÍA, NARESBadia, Josep MVázquez, AnaPera, MiguelParés, DavidLimón, EnricAlmendral, AlexanderPiriz, MartaDíez, CeciliaFraccalvieri, DomenicoLópez-Contreras, JoaquínPujol, MiquelMembers of the VINCat Colorectal Surveillance TeamVINCat ProgramInfecció del lloc quirúrgicRatio d'infecció estandarditzatInfecció de ferides quirúrgiquesPrevenció i controlEstudis de cohortsCirurgia colorrectalEfectes adversosPrevenció i controlInfección del sitio quirúrgicoProporción de infección estandarizadaInfección de la herida quirúrgicaPrevención y controlEstudios de cohortesCirugía colorrectalEfectos adversosPrevención y controlSurgical site infectionStandardized infection ratioSurgical wound infectionPrevention & controlCohort studiesColorectal surgeryAdverse effectsPrevention & control61617Background: 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.info:eu-repo/semantics/publishedVersionElsevier2022info:eu-repo/semantics/article11http://hdl.handle.net/20.500.12328/3355https://dx.doi.org/10.1016/j.ijsu.2022.106611reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésInternational Journal of Surgery102https://www.sciencedirect.com/science/article/pii/S1743919122003880?via%3DihubThis is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).https://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:recercat.cat:20.500.12328/33552026-05-29T05:05:01Z
dc.title.none.fl_str_mv An interventional nationwide surveillance program lowers postoperative infection rates in elective colorectal surgery. A cohort study (2008–2019)
title An interventional nationwide surveillance program lowers postoperative infection rates in elective colorectal surgery. A cohort study (2008–2019)
spellingShingle An interventional nationwide surveillance program lowers postoperative infection rates in elective colorectal surgery. A cohort study (2008–2019)
ARROYO GARCÍA, NARES
Infecció del lloc quirúrgic
Ratio d'infecció estandarditzat
Infecció de ferides quirúrgiques
Prevenció i control
Estudis de cohorts
Cirurgia colorrectal
Efectes adversos
Prevenció i control
Infección del sitio quirúrgico
Proporción de infección estandarizada
Infección de la herida quirúrgica
Prevención y control
Estudios de cohortes
Cirugía colorrectal
Efectos adversos
Prevención y control
Surgical site infection
Standardized infection ratio
Surgical wound infection
Prevention & control
Cohort studies
Colorectal surgery
Adverse effects
Prevention & control
61
617
title_short An interventional nationwide surveillance program lowers postoperative infection rates in elective colorectal surgery. A cohort study (2008–2019)
title_full An interventional nationwide surveillance program lowers postoperative infection rates in elective colorectal surgery. A cohort study (2008–2019)
title_fullStr An interventional nationwide surveillance program lowers postoperative infection rates in elective colorectal surgery. A cohort study (2008–2019)
title_full_unstemmed An interventional nationwide surveillance program lowers postoperative infection rates in elective colorectal surgery. A cohort study (2008–2019)
title_sort An interventional nationwide surveillance program lowers postoperative infection rates in elective colorectal surgery. A cohort study (2008–2019)
dc.creator.none.fl_str_mv ARROYO GARCÍA, NARES
Badia, Josep M
Vázquez, Ana
Pera, Miguel
Parés, David
Limón, Enric
Almendral, Alexander
Piriz, Marta
Díez, Cecilia
Fraccalvieri, Domenico
López-Contreras, Joaquín
Pujol, Miquel
Members of the VINCat Colorectal Surveillance Team
VINCat Program
author ARROYO GARCÍA, NARES
author_facet ARROYO GARCÍA, NARES
Badia, Josep M
Vázquez, Ana
Pera, Miguel
Parés, David
Limón, Enric
Almendral, Alexander
Piriz, Marta
Díez, Cecilia
Fraccalvieri, Domenico
López-Contreras, Joaquín
Pujol, Miquel
Members of the VINCat Colorectal Surveillance Team
VINCat Program
author_role author
author2 Badia, Josep M
Vázquez, Ana
Pera, Miguel
Parés, David
Limón, Enric
Almendral, Alexander
Piriz, Marta
Díez, Cecilia
Fraccalvieri, Domenico
López-Contreras, Joaquín
Pujol, Miquel
Members of the VINCat Colorectal Surveillance Team
VINCat Program
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Infecció del lloc quirúrgic
Ratio d'infecció estandarditzat
Infecció de ferides quirúrgiques
Prevenció i control
Estudis de cohorts
Cirurgia colorrectal
Efectes adversos
Prevenció i control
Infección del sitio quirúrgico
Proporción de infección estandarizada
Infección de la herida quirúrgica
Prevención y control
Estudios de cohortes
Cirugía colorrectal
Efectos adversos
Prevención y control
Surgical site infection
Standardized infection ratio
Surgical wound infection
Prevention & control
Cohort studies
Colorectal surgery
Adverse effects
Prevention & control
61
617
topic Infecció del lloc quirúrgic
Ratio d'infecció estandarditzat
Infecció de ferides quirúrgiques
Prevenció i control
Estudis de cohorts
Cirurgia colorrectal
Efectes adversos
Prevenció i control
Infección del sitio quirúrgico
Proporción de infección estandarizada
Infección de la herida quirúrgica
Prevención y control
Estudios de cohortes
Cirugía colorrectal
Efectos adversos
Prevención y control
Surgical site infection
Standardized infection ratio
Surgical wound infection
Prevention & control
Cohort studies
Colorectal surgery
Adverse effects
Prevention & control
61
617
description 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.
publishDate 2022
dc.date.none.fl_str_mv 2022
dc.type.none.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv http://hdl.handle.net/20.500.12328/3355
https://dx.doi.org/10.1016/j.ijsu.2022.106611
url http://hdl.handle.net/20.500.12328/3355
https://dx.doi.org/10.1016/j.ijsu.2022.106611
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv International Journal of Surgery
102
https://www.sciencedirect.com/science/article/pii/S1743919122003880?via%3Dihub
dc.rights.none.fl_str_mv https://creativecommons.org/licenses/by-nc-nd/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 11
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.811543

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