[Risk factors and length of stay attributable to hospital infections of the urinary tract in general surgery patients].
BACKGROUND
Urinary tract infection (UTI) is the second frequent site of infection in surgical patients; nevertheless, its study has been frequently neglected. The main objective of this report is the analysis of risk factors for ITU in general surgery.


METHODS
A prospective study on 1,483 patients admitted at a service of general surgery for a 20-month study period has been carried out. The criteria used for diagnosing nosocomial were those of the CDC. Crude and adjusted for by logistic regression relative risks and its 95% confidence interval were estimated. To assess the length of stay attributable to UTI, infected patients were 1:1 matched with non-infected patients for surgical procedure, ASA score, age (+/- 10 years), emergency surgery, pre-operative stay, and urinary catheter.


RESULTS
33 patients (2.2%) developed UTI. In crude analysis, UTI risk was significantly associated with urethral catheter (and its duration), advanced age, severity of illness (McCabe-Jackson scale, ASA score, number of diagnoses), type of surgical wound, intrinsic risk of infection (measured by the SENIC and NNIS indices). Stepwise logistic regression analysis selected three independent predictors: urethral catheter, age and pre-operative stay. All urinary drain-ages were open. UTI prolonged hospital stay 4.7 days (95% Cl 3.4-6.2). The use of closed drain-age systems would eliminate 6 UTIs. Assuming a cost per day of hospital stay of $250 the use of closed systems would save $7,000 (IC 95%, 5300-9300).


CONCLUSIONS
The use of closed systems for urethral catheters is cost-saving.
Medina
M
M
Servicio de Cirugía General, Hospital General Ciudad de Jaén.
Martínez-Gallego
G
G
Sillero-Arenas
M
M
Delgado-Rodríguez
M
M
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003363:Cost Control; D003428:Cross Infection / Q000191:economics / Q000453:epidemiology* / Q000517:prevention & control; D004630:Emergencies; D005260:Female; D017721:Hospital Costs; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000191:economics / Q000453:epidemiology* / Q000517:prevention & control; D011446:Prospective Studies; D012306:Risk; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D014546:Urinary Catheterization / Q000295:instrumentation; D014552:Urinary Tract Infections / Q000191:economics / Q000453:epidemiology* / Q000517:prevention & control