Hospital-related determinants for surgical-site infection following hip arthroplasty.
OBJECTIVE
To determine hospital-related risk factors for surgical-site infection (SSI) following hip arthroplasty.


METHODS
Prospective, multicenter cohort study based on surveillance data and data collected through a structured telephone interview. With the use of multilevel logistic regression, the independent effect of hospital-related characteristics on SSI was assessed.


METHODS
Thirty-six acute care hospitals in the Dutch surveillance network for nosocomial infections (PREZIES), from 1996 to 2000.


METHODS
Thirteen thousand six hundred eighty patients who underwent total or partial hip arthroplasty.


RESULTS
A high annual volume of operations was associated with a reduced risk of SSI (risk-adjusted risk ratio [RR] per 50 extra operations, 0.85; 95% confidence interval [CI95], 0.74-0.97). With each extra full-time-equivalent infection control staff member per 250 beds available for prevention of SSI, the risk for SSI was decreased (RR, 0.48; CI95, 0.16-1.44), although the decrease was not statistically significant. Hospital size, teaching status, university affiliation, and number of surgeons and their years of experience showed no important association with the risk of SSI.


CONCLUSIONS
Undergoing surgery in a hospital with a low volume of operations increases a patient's risk of SSI.
Geubbels
Eveline L P E
EL
Department of Infectious Diseases Epidemiology National Institute of Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
Wille
Jan C
JC
Nagelkerke
Nico J D
NJ
Vandenbroucke-Grauls
Christina M J E
CM
Grobbee
Diederick E
DE
de Boer
Annette S
AS
D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D015331:Cohort Studies; D003428:Cross Infection / Q000209:etiology*; D005260:Female; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000209:etiology*