Surgical site infections in neonates are independently associated with longer hospitalizations

Gilje, Elizabeth; Hossain, Jobayer; Vinocur, Charles D.; Berman, Loren

doi:10.1038/jp.2017.107

Cited by 15 publications

(14 citation statements)

References 19 publications

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“…Interestingly, the overall rate of SSI in the neonatal age group in our review is comparable to the rates reported in the older pediatric age group (51, 65, 66). This finding suggests that neonates may be less prone to SSI than it might be expected based on their alleged fragility, as they represent a special population that is thought to be at higher risk for infection due to their immature immune systems (6, 67, 68).…”

Section: Discussionmentioning

confidence: 95%

Risk Factors for Surgical Site Infection in Neonates: A Systematic Review of the Literature and Meta-Analysis

et al. 2019

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Purpose: Surgical site infections (SSI) contribute to postoperative morbidity and mortality in children. Our aim was to evaluate the prevalence and identify risk factors for SSI in neonates. Methods: Using a defined strategy, three investigators searched articles on neonatal SSI published since 2000. Studies on neonates and/or patients admitted to neonatal intensive care unit following cervical/thoracic/abdominal surgery were included. Risk factors were identified from comparative studies. Meta-analysis was conducted according to PRISMA guidelines using RevMan 5.3. Data are (mean ± SD) prevalence. Results: Systematic review—of 885 abstracts screened, 48 studies (27,760 neonates) were included. The incidence of SSI was 5.6% (1,564 patients). SSI was more frequent in males (61.8%), premature babies (77.4%), and following gastrointestinal surgery (95.4%). Meta-analysis—10 comparative studies (16,442 neonates; 946 SSI 5.7%) showed that predictive factors for SSI development were gestational age, birth weight, age at surgery, length of surgical procedure, number of procedure per patient, length of preoperative hospital stay, and preoperative sepsis. Conversely, preoperative antibiotic use was not significantly associated with development of SSI. Conclusions: Younger neonates and those undergoing abdominal procedures are at higher risk for SSI. Given the lack of evidence-based literature, prospective studies may help determine the risk factors for SSI in neonates.

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Section: Discussionmentioning

confidence: 95%

Risk Factors for Surgical Site Infection in Neonates: A Systematic Review of the Literature and Meta-Analysis

et al. 2019

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“…According to literature, SSI leads to delay in wound healing and patient recovery, risk for developing sepsis, and delayed bone union. [4][5][6][7] Despite all the protective measures, infection rate is increasing, thus requiring selection of stringent antibiotics to control the infection. 8,9 To reduce the SSI rate, active safety measures are highly recommended by the World Health Organisation standard guidelines.…”

Section: Surgical Incision Always Carries the Risk Of Developing Surg...mentioning

confidence: 99%

Microbiology of surgical site infection in closed upper limb fractures: data from a prospective trauma registry

2022

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The current study aims to determine the rate of surgical site infection, causal microorganism, and antibiotic sensitivity pattern in operated upper limb closed fractures at the Aga Khan University Hospital, Karachi. Cases presenting between June 2015 to October 2019, were selected from a single-centre, longitudinal, prospective orthopaedic trauma registry. Infection rate, causal microorganism, and antibiotic sensitivity pattern were determined up to six months after surgery. From among a total of 376 closed fractures, 12 encountered surgical site infection with some having late onset, giving an infection rate of 3% which is 1% higher than the international benchmark. Microorganism culture was performed on 5 (42%) patients out of which 2 (40%) were positive. Frequently used prophylactic antibiotics were first generation Cephalosporin and Co-amoxiclav in 9 (75%) patients, but all other the patients required other antibiotic categories. Five patients required implant removal with antibiotic coverage. K-wire insertion required prolonged antibiotic treatment. Most of the cultures were negative in spite of the presence of infection. Key words: Trauma registry, upper limb, closed fractures, wound infection.

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“…Therefore, shortening LOS is a potential way to reduce the pressure and better meet the growing medical needs of T2DM patients with limited resources. Previous studies have focused more on the relationship between LOS and characteristics of patients or disease at individual level, and have ignored the adjustment effects of organizational structure and resource distribution at hospital level [14,20,22]. These efforts cannot effectively reduce LOS caused by factors other than disease and patient characteristics.…”

Section: Plos Onementioning

confidence: 99%

“…Moreover, they are susceptible to adverse events after surgery [19]. This is a particular objective fact for diabetes patients [20,37]. Patients with ICD-10 coded complications types E11.1, E11.2, E11.4, E11.5 and other complications CVDs had longer LOS.…”

Section: Plos Onementioning

confidence: 99%

“…Several measures and efforts have been taken to reduce LOS [12,[14][15][16]. Most of those efforts simply focused on the characteristics of the patient and disease at individual level [17][18][19][20]. Furthermore, some research projects on certain diseases have suggested that a non-negligible part of LOS variations can be explained by the characteristics of organization and resource at hospital level [14,21,22].…”

Section: Introductionmentioning

confidence: 99%

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Understanding variations and influencing factors on length of stay for T2DM patients based on a multilevel model

Shi

et al. 2021

PLoS ONE

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Aim Shortening the length of stay (LOS) is a potential and sustainable way to relieve the pressure that type 2 diabetes mellitus (T2DM) patients placed on the public health system. Method Multi-stage random sampling was used to obtain qualified hospitals and electronic medical records for patients discharged with T2DM in 2018. A box-cox transformation was adopted to normalize LOS. Multilevel model was used to verify hospital cluster effect on LOS variations and screen potential factors for LOS variations from both individual and hospital levels. Result 50 hospitals and a total of 12,888 T2DM patients were included. Significant differences in LOS variations between hospitals, and a hospital cluster effect on LOS variations (t = 92.188, P<0.001) was detected. The results showed that female patients, patients with new rural cooperative’ medical insurance, hospitals with more beds, and hospitals with faster bed turnovers had shorter LOS. Conversely, elderly patients, patients with urban workers’ medical insurance, patients requiring surgery, patients with the International Classification of Diseases coded complication types E11.1, E11.2, E11.4, E11.5, and other complications cardiovascular diseases, grade III hospitals, hospitals with a lower doctor-to-nurse ratio, and hospitals with more daily visits per doctor had longer LOS. Conclusions The evidence proved that hospital cluster effect on LOS variation did exist. Complications and patients features at individual level, as well as organization and resource characteristics at hospital level, had impacted LOS variations to varying degrees. To shorten LOS and better meet the medical demand for T2DM patients, limited health resources must be allocated and utilized rationally at hospital level, and the patients with the characteristics of longer LOS risk must be identified in time. More influencing factors on LOS variations at different levels are still worth of comprehensive exploration in the future.

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Surgical site infections in neonates are independently associated with longer hospitalizations

Cited by 15 publications

References 19 publications

Risk Factors for Surgical Site Infection in Neonates: A Systematic Review of the Literature and Meta-Analysis

Risk Factors for Surgical Site Infection in Neonates: A Systematic Review of the Literature and Meta-Analysis

Microbiology of surgical site infection in closed upper limb fractures: data from a prospective trauma registry

Understanding variations and influencing factors on length of stay for T2DM patients based on a multilevel model

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