Risk factors of hospital infection in surgical sites and its economic losses

doi:10.3877/cma.j.issn.2095-9133.2019.02.006

Abstract

Abstract:

Objective

To understand the risk factors of hospital surgical site infection (SSI) in gastrointestinal surgery and the economic losses caused by it, and to provide a basis for medical institutions to make decisions.

Methods

We investigated the data of 335 patients undergoing gastric, colon and rectal surgery from January to May 2018 in a hospital, and to conduct a retrospective case-control study. Patients who developed SSI (SSI group) were compared with those who underwent the same procedure but did not have SSI (control group) according to the pairing conditions. The risk factors for SSI and the total cost of hospitalization, various detailed expenses, and hospitalization time were analyzed.

Results

The incidence of SSI in 335 patients undergoing gastric, colon, and rectal surgery was 3.88% (13/335). The age at admission, the number of underlying diseases, the time of surgery, preoperative complications with other infections, and urinary catheterization were the risk factors for SSI. The total hospitalization cost of patients in the SSI group was higher than that of the control group [(20 912.8±2 772.8) and (10 798.3±2 393.4)], which was 1.94 times of the total cost of the control group, and the difference was statistically significant (P<0.05).

Conclusions

The age of the patient, the number of underlying diseases, the operation time, preoperative complications with other infections, and urinary catheterization are risk factors for SSI. In addition, SSI prolongs the hospitalization days, increases medical expenses, and affects economic income and medical quality.

Key words: Surgical site infection, Economic loss, Risk factors

Peng Zheng, Qing Bao. Risk factors of hospital infection in surgical sites and its economic losses[J]. Chinese Journal of Hygiene Rescue(Electronic Edition), 2019, 05(02): 97-99.

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References 13

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?	例数(例)	诊疗费[元，M(Q_R)]	手术费[元，M(Q_R)]	麻醉费[元，M(Q_R)]	床位费[元，M(Q_R)]	护理费[元，M(Q_R)]	西药费[元，M(Q_R)]	陪护费[元，M(Q_R)]	总费用(元，±s)
SSI组	13	1 740(1 084)	5 070(3 870)	1 071(530)	1 330(466)	1 017(586)	14 886(11 461)	1 017(586)	20 912.8±2 772.8
对照组	13	1 022(594)	3 056(2 038)	678(417)	860(313)	689(520)	8 054(6 850)	654(405)	10 798.3±2 393.4
χ²/t值	?	2.08	2.39	2.75	2.18	2.18	1.97	1.98	14.62
P值	?	<0.05	<0.05	<0.05	<0.05	<0.05	<0.05	<0.05	<0.05

?	例数(例)	诊疗费[元，M(Q_R)]	手术费[元，M(Q_R)]	麻醉费[元，M(Q_R)]	床位费[元，M(Q_R)]	护理费[元，M(Q_R)]	西药费[元，M(Q_R)]	陪护费[元，M(Q_R)]	总费用(元，±s)
SSI组	13	1 740(1 084)	5 070(3 870)	1 071(530)	1 330(466)	1 017(586)	14 886(11 461)	1 017(586)	20 912.8±2 772.8
对照组	13	1 022(594)	3 056(2 038)	678(417)	860(313)	689(520)	8 054(6 850)	654(405)	10 798.3±2 393.4
χ²/t值	?	2.08	2.39	2.75	2.18	2.18	1.97	1.98	14.62
P值	?	<0.05	<0.05	<0.05	<0.05	<0.05	<0.05	<0.05	<0.05

项目		感染组(n＝13)		未感染(n＝322)		χ²值	P值
项目		例数	构成比	例数	构成比	χ²值	P值
性别		?	?	?	?	?	?
?	男	11	84.62	188	58.39	2.56	>0.05
?	女	2	15.38	134	41.61	2.56	>0.05
年龄(岁)		?	?	?	?	?	?
?	<60	6	46.15	260	80.75	9.14	<0.05
?	≥60	7	53.85	62	19.25	9.14	<0.05
基础疾病(种)		?	?	?	?	?	?
?	≥3	7	53.85	76	23.60	6.4	<0.05
?	1-5	4	30.77	131	40.68	6.4	<0.05
?	无	2	15.38	115	35.71	?	?
手术时间(h)		?	?	?	?	?	?
?	<3	3	23.08	93	28.88	6.46	<0.05
?	3-5	5	38.46	186	57.76	6.46	<0.05
?	≥5	5	38.46	43	13.35	?	?
二次手术		?	?	?	?	?	?
?	是	1	7.69	3	0.93	0.81	>0.05
?	否	12	92.31	319	99.07	0.81	>0.05
术前合并其他感染		?	?	?	?	?	?
?	是	6	46.15	63	19.57	8.88	<0.05
?	否	7	53.85	259	80.43	8.88	<0.05
穿刺与引流		?	?	?	?	?	?
?	是	10	76.92	268	83.23	0.05	>0.05
?	否	3	23.08	54	16.77	0.05	>0.05
化疗与放疗		?	?	?	?	?	?
?	是	11	84.62	226	70.19	0.66	>0.05
?	否	2	15.38	96	29.81	0.66	>0.05
泌尿道插管		?	?	?	?	?	?
?	是	13	100	2	0.62	?	<0.01
?	否	0	0	320	99.38	?	<0.01

项目		感染组(n＝13)		未感染(n＝322)		χ²值	P值
项目		例数	构成比	例数	构成比	χ²值	P值
性别		?	?	?	?	?	?
?	男	11	84.62	188	58.39	2.56	>0.05
?	女	2	15.38	134	41.61	2.56	>0.05
年龄(岁)		?	?	?	?	?	?
?	<60	6	46.15	260	80.75	9.14	<0.05
?	≥60	7	53.85	62	19.25	9.14	<0.05
基础疾病(种)		?	?	?	?	?	?
?	≥3	7	53.85	76	23.60	6.4	<0.05
?	1-5	4	30.77	131	40.68	6.4	<0.05
?	无	2	15.38	115	35.71	?	?
手术时间(h)		?	?	?	?	?	?
?	<3	3	23.08	93	28.88	6.46	<0.05
?	3-5	5	38.46	186	57.76	6.46	<0.05
?	≥5	5	38.46	43	13.35	?	?
二次手术		?	?	?	?	?	?
?	是	1	7.69	3	0.93	0.81	>0.05
?	否	12	92.31	319	99.07	0.81	>0.05
术前合并其他感染		?	?	?	?	?	?
?	是	6	46.15	63	19.57	8.88	<0.05
?	否	7	53.85	259	80.43	8.88	<0.05
穿刺与引流		?	?	?	?	?	?
?	是	10	76.92	268	83.23	0.05	>0.05
?	否	3	23.08	54	16.77	0.05	>0.05
化疗与放疗		?	?	?	?	?	?
?	是	11	84.62	226	70.19	0.66	>0.05
?	否	2	15.38	96	29.81	0.66	>0.05
泌尿道插管		?	?	?	?	?	?
?	是	13	100	2	0.62	?	<0.01
?	否	0	0	320	99.38	?	<0.01

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