Study finds low rate of surgical site infections following ambulatory surgery

February 18, 2014

In an analysis that included nearly 300,000 patients from eight states who underwent ambulatory surgery (surgery performed on a person who is admitted to and discharged from a hospital on the same day), researchers found that the rates of surgical site infections were relatively low; however, the absolute number of patients with these complications is substantial, according to a study in the February 19 issue of JAMA.

Surgical site infections are among the most common health care-associated infections, accounting for 20 percent to 31 percent of health care-associated infections in hospitalized patients, according to background information in the article. Although ambulatory surgeries represent a substantial portion of surgical health care, there is a lack of information on adverse events, including -associated infections.

Pamela L. Owens, Ph.D., of the Agency for Healthcare Research and Quality, Rockville, Md., and colleagues determined the incidence of clinically significant infections (CS-SSIs) following low- to moderate-risk ambulatory surgery in patients with low risk for (defined as not seen in past 30 days in , length of stay less than 2 days, no other surgery on the same day, and discharged home and no infection coded on the same day). The researchers used the 2010 Healthcare Cost and Utilization Project State Ambulatory Surgery and State Inpatient Databases for 8 states (California, Florida, Georgia. Hawaii. Missouri, Nebraska, New York, and Tennessee), representing one-third of the U.S. population. The analysis included 284,098 ambulatory surgical procedures (general surgery, orthopedic, neurosurgical, gynecologic, and urologic) in adult patients; rates were calculated for 14- and 30-day postsurgical acute care visits for CS-SSIs following ambulatory surgery.

The researchers found that the overall rate of postsurgical acute care visits within 14 days for CS-SSIs was relatively low (3.09 per 1,000 ambulatory surgical procedures). When the time frame was extended to 30 days, the rate increased to 4.84. Two-thirds (63.7 percent) of all visits for CS-SSI occurred within 14 days of the surgery; of those visits, 93.2 percent involved treatment in the inpatient setting.

The authors note that although the overall rate of CS-SSIs was low, because of the large number of ambulatory surgical procedures performed annually, in absolute terms, a substantial number of patients develop clinically significant postoperative infections. Most of these infections occurred within 2 weeks after surgery and resulted in hospital admission. "Our findings suggest that earlier access to a clinician or member of the surgical team (e.g., telephone check-in prior to 2 weeks) may help identify and treat these infections early and reduce overall morbidity."

"Prior studies showing significant lapses in control practices at ambulatory surgery centers suggest that quality improvement efforts may facilitate reducing CS-SSIs following ambulatory surgery."

Explore further: Modifiable factors ID'd for reducing surgical site infections

More information: DOI: 10.1001/jama.2014.4

Related Stories

Modifiable factors ID'd for reducing surgical site infections

September 30, 2013
(HealthDay)—Specific modifiable preoperative, intraoperative, and postoperative factors can be optimized to reduce the risk of surgical site infections (SSIs) for patients undergoing elective orthopedic surgery, according ...

Antibiotics before heart surgery protect against infection

December 23, 2013
A new study found preoperative antibiotic therapy administered within two hours of cardiac surgery decreased the risk of developing surgical site infections (SSIs) significantly. The study was published in the January issue ...

Study finds tonsillectomy just as safe for adults as kids

January 30, 2014
(HealthDay)—A new study offers reassurance for adults who need to have their tonsils removed—the procedure has low complication and low death rates.

Inappropriate antibiotic use in emergency rooms not decreasing in adults

January 9, 2014
An analysis of emergency room (ER)visits over a 10-year period finds that while inappropriate antibiotic use is decreasing in pediatric settings, it continues to remain a problem in adults, according to an article published ...

Outpatient urological surgery costs significantly less when performed in physician offices, ACCs

October 22, 2012
More and more outpatient surgical procedures are being done at nonhospital-based facilities such as freestanding ambulatory surgical centers and physician offices, instead of at hospital-based outpatient departments. A new ...

Surgical site infections in pediatric scoliosis reviewed

June 6, 2013
(HealthDay)—Surgical site infections, particularly those caused by gram-negative pathogens, occur more frequently following procedures in patients with non-idiopathic rather than idiopathic scoliosis, according to research ...

Recommended for you

World's first child hand transplant a 'success'

July 19, 2017
The first child in the world to undergo a double hand transplant is now able to write, feed and dress himself, doctors said Tuesday, declaring the ground-breaking operation a success after 18 months.

Knee surgery—have we been doing it wrong?

July 18, 2017
A team of University at Buffalo medical doctors have published a study that challenges a surgical practice used for decades during arthroscopic knee surgery.

New tools help surgeons find liver tumors, not nick blood vessels

July 17, 2017
The liver is a particularly squishy, slippery organ, prone to shifting both deadly tumors and life-preserving blood vessels by inches between the time they're discovered on a CT scan and when the patient is lying on an operating ...

Researchers discover indicator of lung transplant rejection

July 13, 2017
Research by scientists at Dignity Health St. Joseph's Hospital and Medical Center's Norton Thoracic Institute was published in the July 12, 2017 issue of Science Translational Medicine titled "Zbtb7a induction in alveolar ...

New device could make closing surgical incisions a cinch

July 7, 2017
Like many surgeons, Dr. Jason Spector is often faced with the challenge of securely closing the abdominal wall without injuring the intestines. If the process goes awry, there can be serious consequences for patients, including ...

Success with first 20 patients undergoing minimally invasive pancreatic transplant surgery

June 29, 2017
Surgeons at Johns Hopkins Medicine report that their first series of a minimally invasive procedure to treat chronic pancreas disease, known as severe pancreatitis, resulted in shorter hospital stays, less need for opioids ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.