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Am J Infect Control. 2015 Apr 1;43(4):323-8. doi: 10.1016/j.ajic.2014.12.013. Epub 2015 Feb 8.

Surgical site infections after hip arthroplasty in Norway, 2005-2011: influence of duration and intensity of postdischarge surveillance.

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Department of Infectious Disease Epidemiology, Norwegian Institute of Public Health, Oslo, Norway. Electronic address:
Department of Orthopedic Surgery, The Norwegian Arthroplasty Register, Haukeland University Hospital, Bergen, Norway.
Department of Infectious Disease Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.
Epidemi, Lasarettet, Kristiansand, Norway.
Faculty of Health Sciences, Department of Community Medicine, Research Group Epidemiology of Chronic Diseases, UiT The Arctic University of Norway, Tromsø, Norway.



Most surgical site infections (SSIs) after hip arthroplasty are detected after a patient is discharged from hospital, making postdischarge surveillance (PDS) an important component in surveillance systems. We investigated how long it was necessary to monitor hip arthroplasty patients for SSIs after hospital discharge and if passive PDS through readmissions could replace active PDS by patient questionnaire in detecting SSIs.


We used data from the Norwegian surveillance system from 2005-2011, which has active 1-year PDS, to investigate proportions of SSIs found at different time intervals after surgery and whether these SSIs could have been detected through passive PDS by investigating the proportion of patients with SSIs that were readmitted.


We found that 79% of all SSIs and 82% of deep SSIs were detected after hospital discharge. 95% of deep SSIs were detected within 90 days after surgery. 14% of the deep SSIs were detected beyond 30 days after surgery, and all of these patients were readmitted because of their SSI and thus could have been detected by passive PDS.


Our data suggest that most deep SSIs are detected within 90 days and that passive PDS beyond 30 days after surgery may replace active PDS without reducing sensitivity.


Electronic; Length of stay; Readmission; Surgical wound infection

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