Zuo Qiuxia, Liu Di, Dong Baoji, Zhou Yuan, Zhao Kexin, Tian Ping
School of Nursing, Xinjiang Medical University, Urumqi, Xinjiang, China.
Infection Management Department, The Fifth Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
Front Public Health. 2025 Jan 13;12:1514444. doi: 10.3389/fpubh.2024.1514444. eCollection 2024.
Surgical site infection (SSI) represents a significant postoperative complication, resulting in extended hospital stays and substantial economic burdens. Previous research on the direct economic impact of SSIs using recursive systems modeling is limited. This study aims to quantify the direct economic losses attributable to SSIs and to dissect the various factors to these losses.
A retrospective 1:1 matched case-control study was conducted from January 2023 to March 2024 in three tertiary hospitals in Xinjiang, China. Patients with SSIs were matched on a 1:1 basis by hospital, department, age (±5 years), sex, primary diagnosis, and procedure with controls to form case and control groups. Wilcoxon Signed Ranks Test was utilized to quantify the direct economic loss from SSIs. Influencing factors were analyzed using a recursive system model.
Among the 74,258 patients surveyed, 226 developed SSIs, resulting in an infection rate of 0.3%. The total direct economic loss from SSIs at three hospitals was $467,867, with an average loss of $1,364.37 per SSI patient. SSI patients experienced hospital stays 11 days longer than uninfected patients. Multivariate linear regression identified the duration of hospital stay, catheter and ventilator usage, age, number of surgeries, and duration of antibiotic treatment as influencing factors. Recursive system modeling revealed the indirect contributions of the number of surgeries (indirect effect: 0.074), antibiotic use for 17-36 days (indirect effect: 0.063) and ≥ 37 days (indirect effect: 0.045), and debridement procedures (indirect effect: 0.054), as well as the direct contributions of hospital days (direct effect: 0.276), indwelling catheter days (direct effect: 0.260), ventilator days (direct effect: 0.221), and age (direct effect: 0.182).
Recursive system modeling helped identify the key factors influencing the economic losses from SSIs. These findings provide a theoretical basis for healthcare departments to develop targeted policies.
手术部位感染（SSI）是一种严重的术后并发症，会导致住院时间延长和巨大的经济负担。以往使用递归系统模型对SSI的直接经济影响进行的研究有限。本研究旨在量化SSI造成的直接经济损失，并剖析造成这些损失的各种因素。
2023年1月至2024年3月在中国新疆的三家三级医院进行了一项回顾性1:1配对病例对照研究。SSI患者按医院、科室、年龄（±5岁）、性别、初步诊断和手术与对照进行1:1配对，形成病例组和对照组。采用Wilcoxon符号秩检验来量化SSI造成的直接经济损失。使用递归系统模型分析影响因素。
在调查的74258名患者中，226人发生了SSI，感染率为0.3%。三家医院因SSI造成的直接经济损失总计467867美元，每名SSI患者平均损失1364.37美元。SSI患者的住院时间比未感染患者长11天。多变量线性回归确定住院时间、导管和呼吸机使用情况、年龄、手术次数以及抗生素治疗时间为影响因素。递归系统模型揭示了手术次数（间接效应：0.074）、使用抗生素17 - 36天（间接效应：0.063）和≥37天（间接效应：0.045）以及清创手术（间接效应：0.054）的间接贡献，以及住院天数（直接效应：0.276）、留置导管天数（直接效应：0.260）、呼吸机使用天数（直接效应：0.221）和年龄（直接效应：0.182）的直接贡献。
递归系统模型有助于确定影响SSI经济损失的关键因素。这些发现为医疗部门制定针对性政策提供了理论依据。
