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首页> 外文期刊>Infection control and hospital epidemiology >Impact of postdischarge surveillance on the rate of surgical site infection after orthopedic surgery.
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Impact of postdischarge surveillance on the rate of surgical site infection after orthopedic surgery.

机译：出院后监测对骨科手术后手术部位感染率的影响。

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OBJECTIVE: To evaluate the impact of postdischarge surveillance on surgical site infection (SSI) rates after orthopedic surgery. SETTING: Nine hospitals participating in the Finnish Hospital Infection Program. PATIENTS: All patients who underwent hip or knee arthroplasty or open reduction of a femur fracture during 1999-2002. RESULTS: The date of discharge was available for 11,812 procedures (90%). The median length of hospital stay was 8 days (range per hospital, 6-9 days). The overall SSI rate was 3.3% (range, 0.8%-6.4%). Of 384 SSIs detected, 216 (56%; range, 28%-90%) were detected after discharge: 93 (43%) were detected on readmission to the hospital, 73 (34%) at completion of a postdischarge questionnaire, and 23 (11%) at a follow-up visit. For 27 postdischarge SSIs (13%), the location of detection was unknown. Altogether, 32 (86%) of 37 of organ/space SSIs, 57 (80%) of 71 deep incisional SSIs, and 127 (46%) of 276 superficial incisional SSIs were detected after discharge. Most SSIs (70%) detectedon readmission were severe (organ/space or deep incisional), whereas most SSIs (86%) detected at follow-up visits or at completion of a postdischarge questionnaire were superficial. Of all SSIs, 78% (range, 48%-100%) were microbiologically confirmed. Microbiologic confirmation was less common after discharge than during postoperative hospital stay (66% vs 93%; P<.001). CONCLUSIONS: Postdischarge surveillance had a large impact on the rate of SSI detected after orthopedic surgery. However, postdischarge surveillance conducted by means of a questionnaire detected only a minority of deep incisional and organ/space SSIs.
机译：目的：评估出院后监测对骨科手术后手术部位感染率的影响。地点：九家医院参加了芬兰医院感染计划。患者：1999-2002年间接受髋关节或膝关节置换术或股骨骨折开放复位术的所有患者。结果：出院日期可用于11,812例手术（占90％）。住院时间的中位数为8天（每家医院6-9天不等）。总体SSI率为3.3％（范围为0.8％-6.4％）。在出院后发现的384个SSI中，有216个（56％;范围，28％-90％）被发现：再次入院时被发现93（43％），出院后调查问卷完成时被发现73（34％），23 （11％）进行随访。对于27个放电后SSI（13％），检测位置未知。出院后共检出37个器官/空间SSI中的32个（86％），71个深切面SSI中的57个（80％）和276个浅切面SSI中的127个（46％）。再入院时检测到的大多数SSI（70％）是严重的（器官/空间或深切缘），而在随访访视时或出院后调查问卷完成时检测到的大多数SSI（86％）是肤浅的。在所有SSI中，有78％（范围为48％-100％）被微生物学证实。出院后的微生物学确认要比术后住院期间少见（66％比93％; P <.001）。结论：出院后监测对骨科手术后SSI的检出率有很大影响。然而，通过问卷调查进行的出院后监测仅检测到少数深切入和器官/空间SSI。

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