Detection of Postoperative Surgical-Site Infections: Comparison of Health Plan–Based Surveillance With Hospital-Based Programs

Abstract

Surveillance based on health plan data identified more postoperative infections, including those occurring before discharge, than did hospital-based surveillance. Screening administrative data and pharmacy activity may be an important adjunct to SSI surveillance, allowing efficient comparison of hospital-specific rates. Interpretation of differences among hospitals' infection rates requires case mix adjustment and understanding of variations in hospitals' discharge diagnosis coding practices.

Surgical site infections after lung resection: a prospective study of risk factors in 1,091 consecutive patients

“…Moreover, a relevant proportion of postoperative infections develop after hospital discharge, and it has been emphasized that reliable methods for identifying post-discharge infections are necessary to capture all events (5). According to few thoracic surgeons, a controversial issue is grouping wound infection, pneumonia and empyema; however, including all these are in adherence to CDC definitions (6,7).…”

“…The most widely used definitions for SSIs are those provided by the Centers for Diseases Control (CDC) in 1992, updated in 2003. Accordingly, surgical infections are commonly categorized into incisional and organ/space SSIs (6,7). In detail, the CDC defined incisional SSI those involving the skin and subcutaneous tissue (superficial incisional SSI) and those involving deep soft tissues of the incision (deep incisional SSI).…”

Use of Medicare Diagnosis and Procedure Codes to Improve Detection of Surgical Site Infections following Hip Arthroplasty, Knee Arthroplasty, and Vascular Surgery

“…Surveillance based on routinely col-lected health data, including inpatient and outpatient claims, has repeatedly been shown to increase identification of SSIs when compared with traditional surveillance by hospital infection prevention programs. [5][6][7][8][9][10] These demonstrations of increased detection include the use of Medicare claims data to identify SSI following coronary artery bypass graft (CABG) surgery. 11,12 We explored the potential usefulness of coded diagnoses and procedures captured in claims as the primary trigger for chart review aimed at identifying SSIs after hip arthroplasty, knee arthroplasty, and vascular surgery.…”

Methodology of the Norwegian Surveillance System for Healthcare-Associated Infections: The value of a mandatory system, automated data collection, and active postdischarge surveillance

“…Some have utilized advanced algorithms to detect SSIs and validate these against ICP case-finding. 83,88,185,[190][191][192][193][194][195][196][197][198][199] Computer systems should reduce the workload on ICPs, thereby making all-year surveillance of several procedures an achievable goal for surveillance systems.…”