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J Am Geriatr Soc. 2009 Jan;57(1):46-54. doi: 10.1111/j.1532-5415.2008.02053.x.

The effect of surgical site infection on older operative patients.

Author information

  • 1Duke University Medical Center, Durham, North Carolina, USA. kkaye@med.wayne.edu

Abstract

OBJECTIVES:

To determine the effect of surgical site infection (SSI) on mortality, duration of hospitalization, and hospital cost in older operative patients.

DESIGN:

Retrospective matched-outcomes study.

SETTING:

Eight hospitals, including Duke University Medical Center, and seven community hospitals.

PARTICIPANTS:

Patients aged 65 and older undergoing surgery from 1991 to 2003. Cases were defined as patients who developed deep incisional or organ or space SSI; controls were operative patients who did not develop SSI. Controls were frequency matched to cases according to type and year of operative procedure and to hospital in a 1:1 ratio.

MEASUREMENTS:

Mortality, duration of hospitalization (including re-admissions), and hospital charges for the 90 days after surgery.

RESULTS:

One thousand three hundred thirty-seven patients were enrolled in the study: 561 cases with SSI and 576 controls without SSI. In cases, the most common SSI pathogen was Staphylococcus aureus (n=275, 51.6%). Of S. aureus isolates, 58.2% were methicillin resistant. One hundred sixteen subjects died within 90 days of surgery (8.6%). In multivariable analysis, SSI was associated with greater mortality risk (odds ratio (OR)=3.51, 95% confidence interval (CI)=2.20-5.59), 2.9 times longer postoperative hospitalization (95% CI=2.61-3.13), and 1.9 times greater hospital charges (95% CI=1.78-2.10).

CONCLUSION:

In elderly operative patients, SSI was associated with almost 4 times greater mortality, a mean attributable duration of hospitalization after surgery of 15.7 days (95% CI=13.9-17.6) and mean attributable hospital charges of $43,970 (95% CI=$31,881-56,060).

PMID:
19054183
[PubMed - indexed for MEDLINE]
PMCID:
PMC2729123
Free PMC Article
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