Academic Vascular Surgical Unit, Hull York Medical School, Hull, UK.
Department of Plastic and Reconstructive Surgery, Castle Hill Hospital, Cottingham, UK.
Int Wound J. 2021 Jun;18(3):261-268. doi: 10.1111/iwj.13526. Epub 2020 Dec 16.
Surgical site infections (SSI) substantially increase costs for healthcare providers because of additional treatments and extended patient recovery. The objective of this study was to assess the cost and health-related quality of life impact of SSI, from the perspective of a large teaching hospital in England. Data were available for 144 participants undergoing clean or clean-contaminated vascular surgery. SSI development, length of hospital stay, readmission, and antibiotic use were recorded over a 30-day period. Patient-reported EQ-5D scores were obtained at baseline, day 7 and day 30. Linear regressions were used to control for confounding variables. A mean SSI-associated length of stay of 9.72 days resulted in an additional cost of £3776 per patient (including a mean antibiotic cost of £532). Adjusting for age, smoking status, and procedure type, SSI was associated with a 92% increase in length of stay (P < 0.001). The adjusted episode cost was £3040. SSI reduced patient utility between baseline and day 30 by 0.156 (P = 0.236). Readmission rates were higher with SSI (P = 0.017), and the rate to return to work within 90 days was lower. Therefore, strategies to reduce the risk of surgical site infection for high-risk vascular patients should be investigated.
手术部位感染（SSI）会显著增加医疗保健提供者的成本，因为需要额外的治疗和延长患者的康复时间。本研究的目的是从英国一所大型教学医院的角度评估 SSI 的成本和健康相关生活质量的影响。共有 144 名接受清洁或清洁污染血管手术的参与者提供了数据。在 30 天的时间内记录 SSI 的发展、住院时间、再入院和抗生素的使用情况。在基线、第 7 天和第 30 天获得了患者报告的 EQ-5D 评分。线性回归用于控制混杂变量。SSI 导致的平均住院时间延长 9.72 天，每位患者的额外成本为 3776 英镑（包括平均抗生素成本 532 英镑）。在调整年龄、吸烟状况和手术类型后，SSI 与住院时间延长 92%相关（P<0.001）。调整后的发作成本为 3040 英镑。SSI 导致患者在基线和第 30 天之间的效用降低了 0.156（P=0.236）。SSI 导致再入院率更高（P=0.017），90 天内恢复工作的比例更低。因此，应研究降低高危血管患者手术部位感染风险的策略。
