[Quality improvement program of nosocomial infection in colorectal cancer surgery].
OBJECTIVE
The surgical-site infection (SSI) is a complication of colorectal neoplasia surgery. The objectives of the study were to identify the SSI risk factors associated with colon surgery and to describe a strategy of quality improvement using surgical-site rates.


METHODS
Prospective cohort study of in-patients undergoing neoplasia colorectal surgery between 1st July 2002 to 30th June 2003. A descriptive analysis was implemented. Benchmarking was used as tool of quality improvement, and the outcomes were measured using the standardized infection ratio (SIR). To define the risk factors, the Chi square test and logistic regression test were used in univariate and multivariate analysis, respectively.


RESULTS
148 patients were included in the study. The SSI accumulative incidence rate (IA) was 10.14%, and the incidence rate was 6.47 SSI per 1000 days. The SIR was 1.53 the first semester and 1.02 the second one. The multivariate analysis identified two risk factors associated with SSI: unscheduled admission (odds ratio [OR] = 7.47, 95% confidence interval [CI] 2.03-27.48) and a risk index of American Society of Anaesthesiologists (ASA) > or = 3 (OR = 6.77, IC 95%, 1.15-39.84).


CONCLUSIONS
An unscheduled admission and high risk ASA index were risk factors associated with SSI in patients undergoing colorectal surgery. The program of quality improvement based on benchmark achieved a reduction of SSI rates similar to the standard ones.
Jesús Hernández-Navarrete
M
M
Servicio de Medicina Preventiva y Salud Pública, Hospital Universitario Miguel, Zaragoza, Spain. mjhernandezn@salud.aragon.es
Arribas-Llorente
José Luis
JL
Solano-Bernad
Víctor Manuel
VM
Misiego-Peral
Antonio
A
Rodríguez-García
Juan
J
Fernández-García
José Luis
JL
Martínez-Germán
Antonio
A
D000368:Aged; D015179:Colorectal Neoplasms / Q000601:surgery*; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors