Impact of surgical site infections after open and laparoscopic colon and rectal surgeries on postoperative resource consumption

Haruhisa Fukuda, K. Morikane, M. Kuroki, S. Kawai, K. Hayashi, Y. Ieiri, H. Matsukawa, K. Okada, F. Sakamoto, T. Shinzato, S. Taniguchi

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Purpose To estimate the impact of surgical site infection (SSI) on postoperative resource consumption for colon and rectal open and laparoscopic surgeries after accounting for infection depth and patient characteristics, and to compare these estimates among institutions. Methods We collected administrative and SSI-related data from eight Japanese hospitals, and used generalized linear models to estimate excess postoperative length of stay (LOS) and charges attributable to SSI. Covariates included wound class, American Society of Anesthesiologists (ASA) score, operation time, emergency, colostomy, trauma, implant, and comorbidities. Results We examined 1,108 colon surgery (CS) and 477 rectal surgery (RS) patients. For open surgery, the postoperative LOS in non-SSI patients was 13.5 (CS) and 15.9 days (RS). Compared with non-SSI patients, the postoperative LOS increased by 4.5 (CS) and 2.8 days (RS) for superficial SSI, 6.8 (CS) and 8.5 days (RS) for deep SSI, and 7.8 and 9.5 days for space/organ SSI. For laparoscopic surgery, the postoperative LOS was 9.8 (CS) and 14.6 days (RS). SSI was significantly associated with increased postoperative LOS for superficial SSI [by 4.8 (CS) and 3.6 days (RS)], deep SSI [by 10.3 (CS) and 23.9 days (RS)], and space/organ SSI [by 8.9 days (RS)]. The postoperative LOS among hospitals was 3.8-10.4 days (CS) and 1.3-12.2 days (RS). Postoperative SSI-attributable charges ranged from $386 to $2,873, depending on organ, procedure, and infection depth. Conclusion This study quantified the impact of SSIs on resource consumption and confirmed significant cost variations among hospitals. These variations could not be explained by patient characteristics or infection type.

Original languageEnglish
Pages (from-to)649-659
Number of pages11
JournalInfection
Volume40
Issue number6
DOIs
Publication statusPublished - Dec 1 2012
Externally publishedYes

Fingerprint

Surgical Wound Infection
Colon
Ambulatory Surgical Procedures
Length of Stay
Infection
Laparoscopy
Colostomy
Wounds and Injuries
Comorbidity
Linear Models
Emergencies

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Impact of surgical site infections after open and laparoscopic colon and rectal surgeries on postoperative resource consumption. / Fukuda, Haruhisa; Morikane, K.; Kuroki, M.; Kawai, S.; Hayashi, K.; Ieiri, Y.; Matsukawa, H.; Okada, K.; Sakamoto, F.; Shinzato, T.; Taniguchi, S.

In: Infection, Vol. 40, No. 6, 01.12.2012, p. 649-659.

Research output: Contribution to journalArticle

Fukuda, H, Morikane, K, Kuroki, M, Kawai, S, Hayashi, K, Ieiri, Y, Matsukawa, H, Okada, K, Sakamoto, F, Shinzato, T & Taniguchi, S 2012, 'Impact of surgical site infections after open and laparoscopic colon and rectal surgeries on postoperative resource consumption', Infection, vol. 40, no. 6, pp. 649-659. https://doi.org/10.1007/s15010-012-0317-7
Fukuda, Haruhisa ; Morikane, K. ; Kuroki, M. ; Kawai, S. ; Hayashi, K. ; Ieiri, Y. ; Matsukawa, H. ; Okada, K. ; Sakamoto, F. ; Shinzato, T. ; Taniguchi, S. / Impact of surgical site infections after open and laparoscopic colon and rectal surgeries on postoperative resource consumption. In: Infection. 2012 ; Vol. 40, No. 6. pp. 649-659.
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abstract = "Purpose To estimate the impact of surgical site infection (SSI) on postoperative resource consumption for colon and rectal open and laparoscopic surgeries after accounting for infection depth and patient characteristics, and to compare these estimates among institutions. Methods We collected administrative and SSI-related data from eight Japanese hospitals, and used generalized linear models to estimate excess postoperative length of stay (LOS) and charges attributable to SSI. Covariates included wound class, American Society of Anesthesiologists (ASA) score, operation time, emergency, colostomy, trauma, implant, and comorbidities. Results We examined 1,108 colon surgery (CS) and 477 rectal surgery (RS) patients. For open surgery, the postoperative LOS in non-SSI patients was 13.5 (CS) and 15.9 days (RS). Compared with non-SSI patients, the postoperative LOS increased by 4.5 (CS) and 2.8 days (RS) for superficial SSI, 6.8 (CS) and 8.5 days (RS) for deep SSI, and 7.8 and 9.5 days for space/organ SSI. For laparoscopic surgery, the postoperative LOS was 9.8 (CS) and 14.6 days (RS). SSI was significantly associated with increased postoperative LOS for superficial SSI [by 4.8 (CS) and 3.6 days (RS)], deep SSI [by 10.3 (CS) and 23.9 days (RS)], and space/organ SSI [by 8.9 days (RS)]. The postoperative LOS among hospitals was 3.8-10.4 days (CS) and 1.3-12.2 days (RS). Postoperative SSI-attributable charges ranged from $386 to $2,873, depending on organ, procedure, and infection depth. Conclusion This study quantified the impact of SSIs on resource consumption and confirmed significant cost variations among hospitals. These variations could not be explained by patient characteristics or infection type.",
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T1 - Impact of surgical site infections after open and laparoscopic colon and rectal surgeries on postoperative resource consumption

AU - Fukuda, Haruhisa

AU - Morikane, K.

AU - Kuroki, M.

AU - Kawai, S.

AU - Hayashi, K.

AU - Ieiri, Y.

AU - Matsukawa, H.

AU - Okada, K.

AU - Sakamoto, F.

AU - Shinzato, T.

AU - Taniguchi, S.

PY - 2012/12/1

Y1 - 2012/12/1

N2 - Purpose To estimate the impact of surgical site infection (SSI) on postoperative resource consumption for colon and rectal open and laparoscopic surgeries after accounting for infection depth and patient characteristics, and to compare these estimates among institutions. Methods We collected administrative and SSI-related data from eight Japanese hospitals, and used generalized linear models to estimate excess postoperative length of stay (LOS) and charges attributable to SSI. Covariates included wound class, American Society of Anesthesiologists (ASA) score, operation time, emergency, colostomy, trauma, implant, and comorbidities. Results We examined 1,108 colon surgery (CS) and 477 rectal surgery (RS) patients. For open surgery, the postoperative LOS in non-SSI patients was 13.5 (CS) and 15.9 days (RS). Compared with non-SSI patients, the postoperative LOS increased by 4.5 (CS) and 2.8 days (RS) for superficial SSI, 6.8 (CS) and 8.5 days (RS) for deep SSI, and 7.8 and 9.5 days for space/organ SSI. For laparoscopic surgery, the postoperative LOS was 9.8 (CS) and 14.6 days (RS). SSI was significantly associated with increased postoperative LOS for superficial SSI [by 4.8 (CS) and 3.6 days (RS)], deep SSI [by 10.3 (CS) and 23.9 days (RS)], and space/organ SSI [by 8.9 days (RS)]. The postoperative LOS among hospitals was 3.8-10.4 days (CS) and 1.3-12.2 days (RS). Postoperative SSI-attributable charges ranged from $386 to $2,873, depending on organ, procedure, and infection depth. Conclusion This study quantified the impact of SSIs on resource consumption and confirmed significant cost variations among hospitals. These variations could not be explained by patient characteristics or infection type.

AB - Purpose To estimate the impact of surgical site infection (SSI) on postoperative resource consumption for colon and rectal open and laparoscopic surgeries after accounting for infection depth and patient characteristics, and to compare these estimates among institutions. Methods We collected administrative and SSI-related data from eight Japanese hospitals, and used generalized linear models to estimate excess postoperative length of stay (LOS) and charges attributable to SSI. Covariates included wound class, American Society of Anesthesiologists (ASA) score, operation time, emergency, colostomy, trauma, implant, and comorbidities. Results We examined 1,108 colon surgery (CS) and 477 rectal surgery (RS) patients. For open surgery, the postoperative LOS in non-SSI patients was 13.5 (CS) and 15.9 days (RS). Compared with non-SSI patients, the postoperative LOS increased by 4.5 (CS) and 2.8 days (RS) for superficial SSI, 6.8 (CS) and 8.5 days (RS) for deep SSI, and 7.8 and 9.5 days for space/organ SSI. For laparoscopic surgery, the postoperative LOS was 9.8 (CS) and 14.6 days (RS). SSI was significantly associated with increased postoperative LOS for superficial SSI [by 4.8 (CS) and 3.6 days (RS)], deep SSI [by 10.3 (CS) and 23.9 days (RS)], and space/organ SSI [by 8.9 days (RS)]. The postoperative LOS among hospitals was 3.8-10.4 days (CS) and 1.3-12.2 days (RS). Postoperative SSI-attributable charges ranged from $386 to $2,873, depending on organ, procedure, and infection depth. Conclusion This study quantified the impact of SSIs on resource consumption and confirmed significant cost variations among hospitals. These variations could not be explained by patient characteristics or infection type.

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