Department of Nursing and Community Health, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.
Department of Nursing and Community Health, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.
J Hosp Infect. 2020 Sep;106(1):76-101. doi: 10.1016/j.jhin.2020.05.011. Epub 2020 May 15.
Surgical site infections (SSIs) present a significant burden to healthcare and patients in terms of excess length of stay, distress, disability and death. SSI risk and the associated economic burden may be reduced through adherence to prevention guidelines although the irreducible minimum is unclear.
To evaluate the methods used to estimate the cost-effectiveness of prevention strategies for all SSIs.
PubMed, Medline, CINAHL, and UK National Health Service Economic Evaluation Database were searched from inception to January 2020 to identify English language economic evaluation studies, embedded economic evaluations, and studies with some analysis in relation to cost and benefit in adult patients receiving surgical care in any setting. Risk of bias was assessed using two published checklists.
Thirty-two studies involving 24,043 participants were included. Most studies evaluated SSI prevention in orthopaedic surgeries. Antibiotic prophylaxis, screening, treating, or decolonization of meticillin-resistant Staphylococcus aureus and surgical wound closure were the main methods evaluated. Methods ranged from cost-analyses to cost-effectiveness and cost-utility analyses. Synthesis of results was not possible due to heterogeneity. All studies reported some economic benefit associated with preventing SSI; however, measures of benefit were not reported consistently and the quality of studies was low to moderate. Limited evidence in relation to SSI impact on quality of life was identified.
Current evidence in relation to the economic benefits of SSI prevention is limited. Further robust studies that utilize sound economic and epidemiological methods are required to inform future investment decisions in SSI prevention.
手术部位感染（SSI）会导致患者住院时间延长、痛苦增加、残疾和死亡，给医疗保健和患者带来巨大负担。虽然通过遵守预防指南可以降低 SSI 风险和相关的经济负担，但降低的幅度尚不清楚。
评估评估所有 SSI 预防策略的成本效益的方法。
从建库到 2020 年 1 月，通过检索 PubMed、Medline、CINAHL 和英国国家卫生服务经济评价数据库，以确定在任何环境下接受外科护理的成年患者中，与成本和效益相关的、评估所有 SSI 预防策略的成本效益的经济评估研究、嵌入式经济评估以及具有一些分析的研究。使用两个已发表的清单评估偏倚风险。
共纳入 32 项研究，涉及 24043 名参与者。大多数研究评估了骨科手术中的 SSI 预防。抗生素预防、筛查、治疗或耐甲氧西林金黄色葡萄球菌去定植以及手术伤口闭合是主要评估方法。方法范围从成本分析到成本效益和成本效用分析。由于异质性，无法对结果进行综合分析。所有研究均报告了预防 SSI 相关的一些经济效益；然而，效益的衡量标准并未得到一致报告，且研究质量较低至中等。仅发现与 SSI 对生活质量影响相关的有限证据。
目前有关 SSI 预防的经济效益的证据有限。需要进一步开展使用可靠的经济和流行病学方法的稳健研究，为未来的 SSI 预防投资决策提供信息。
