Abstract
The objective was to know the principal risk factors that influence in the development of surgical would infection, and the economical saving achieved with the control of a single variable, that is, right prophylaxis. A prospective study was carried out at the Traumatology Department of La Paz Hospital. A total of 5260 patients operated during 1990–1993 are included. Active epidemiological surveillance was used to check patients; logistic regression was used in the multivariant analysis. The principal risk factors found were: immunodeficiency (OR = 8.67), incorrect healing (OR = 14.42), re-operated patient (patients who needed more than one surgical procedure while they are admitted; reoperations) (OR = 3.57), type of surgery (OR = 4.71) and wrong prophylaxis (OR = 6.36). Making constant all the variables except for prophylaxis, we calculated the percentage of infections prevented by a right prophylaxis, and the cost was calculated starting from the number of extra days of infection. The number of infections prevented during the four years was 310, saving a total of 194 million pesetas (1.5 million dollars), due to right prophylaxis. Cost-benefice ratio = 1/17. We consider of special importance to control this manipulable risk factor, in order to avoid the development of infections.
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Haley RW. Infection surveillance and control programs. In: Bennett (ed), Hospital infections. Little Brown, Boston 1986; 39–51.
Ehrenkranz NJ, Meakins JL. Surgical infections. In: Bennett and Brachman (eds), Hospital infections. Little Brown, Boston 1992; 58–72.
Haley RW. Cost-benefit analysis of infection control programs. In: Bennett and Brachman (eds), Hospital infections. Little Brown, Boston 1994; 507–532.
Haley RW. Measuring the cost of nosocomial infections: Methods for estimating economic burden on the hospital. Am J Med 1991; 91: 32–37.
Broderick A, Morin M, Nettleman MD, et al. Nosocomial infection: Validation of surveillance and computer modeling to identify patients at risk. Am J Epidemiol 1990; 131: 734–742.
Cruse P. Surgical infections: Incisional wounds. In: Bennet and Brachman (eds), Hospital infections. Little Brown, Boston 1992; 423–436.
Comisión Clinica de infecciones del Hospital La Paz de Madrid. Normas recomendadas para la prevención y control de la infección hospitalaria. 1991.
Gadner JS, Jarvis WR, Emori TG. CDC definitions for nosocomial infections. 1988. Am J Inf C 1988; 16: 128–140.
Hosmer DW, Lemmeshow S. Model-building strategies and methods for logistic regression. In Wiley Interscience editores. Applied logistic regression. 1990, 83–134.
Kleinbaum DG, Kupper LL, Muller KE. Dummy variables in regression. In PWS-KENT edit. Applied regression analysis and others multivariable methods. Boston 1988; 260–296.
Haley RW. Infection surveillance and control programs. In: Bennett (ed), Hospital infections. Little Brown, Boston 1985: 39–51.
Haley RW, Quade D, Freeman HE, et al. Study on the efficacy of nosocomial infection control program (SENIC PROYECT). Am J Epidemiol 1980; 111: 472–485.
Haley RW, Culver DH, Emori TG, et al. Progress report on the evaluation of the efficacy of infection surveillance and control programs. Am J Med 1981; 70: 971–975.
Wenzel P, Pfaller MA. Infection control: The premier quality assessment program in United States hospitals. Am J Med 1991; 91: 27–31.
Haley RW, Shachtman RH. The emergence of infection surveillance and control programs in US hospitals: An assessment, 1976. Am J Epidemiol 1980; 111: 472–485.
Tager IB, Ginsberg MB, Simchen E, et al. Rationale and methods for a standarwide prospective surveillance system for the identification and prevention of nosocomial infections. Rev Infec Dis 1981; 3: 683–693.
Evans RS, Burke JP, Classen DC, et al. Computerized identification of patient at high risk for hospital-acquired infection. AJIC 1992; 20: 4–10.
Wakefield DS, Helms CM, Massanari RM, et al. Cost of nosocomial infection: Relative contributions of laboratory, antibiotic, and per diem cost in serious Staphylococcus aureus infections. AJIC 1988; 16: 185–192.
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Fernandez Arjona, M., Herruzo Cabrera, R., Gomez-Sancha, F. et al. Economical saving due to prophylaxis in the prevention of surgical wound infection. Eur J Epidemiol 12, 455–459 (1996). https://doi.org/10.1007/BF00143996
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DOI: https://doi.org/10.1007/BF00143996