title: Impact of inadequate surgical antibiotic prophylaxis on perioperative outcome and length of stay on ICU in general and trauma surgery. Analysis using automated data collection.
abstract: Within surgical departments, a large amount of antibiotics is used for perioperative prophylaxis. Despite the existence of several guidelines and recommendations for administering antibiotic prophylaxis, mistakes still do occur and have an unknown impact on outcome severity. Based on the electronic anaesthesia records of 4304 patients undergoing defined surgical procedures requiring perioperative antibiotic prophylaxis, a matched pairs approach was used to evaluate the impact of inadequate antibiotic prophylaxis on hospital mortality and prolonged length of stay on intensive care. Stepwise regression models were developed to predict the impact of inadequate antibiotic prophylaxis on outcome measures. An inadequate antibiotic prophylaxis was found for a total of 877 cases. 77.9% of cases were successfully matched, leading to 683 cases and controls each. The crude mortality ratio of cases to controls was 1.5 (cases = 21 versus controls = 14; P = 0.19). The case group had a significantly (P < 0.01) prolonged stay on ICU when analysed as a metric variable. Using logistic regression analysis, we could determine that inadequate antibiotic prophylaxis had no impact on either hospital mortality or prolonged length of stay on ICU (>1 day; yes or no).
authors.affiliation: Department of Anesthesiology, Intensive Care Medicine, and Pain Therapy, University Hospital Giessen, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Hartmann
authors.forename: Jochen
authors.initials: J
authors.lastname: Sucke
authors.forename: Dominik
authors.initials: D
authors.lastname: Brammen
authors.forename: Andreas
authors.initials: A
authors.lastname: Jost
authors.forename: Alexander
authors.initials: A
authors.lastname: Eicher
authors.forename: Rainer
authors.initials: R
authors.lastname: Röhrig
authors.forename: Axel
authors.initials: A
authors.lastname: Junger
mesh_terms: D019072:Antibiotic Prophylaxis; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D009026:Mortality; D019990:Perioperative Care; D011183:Postoperative Complications / Q000517:prevention & control*; D011787:Quality of Health Care / Q000706:statistics & numerical data*