Economic burden of surgical site infections at a European university hospital.
OBJECTIVE
To quantify the economic burden of in-hospital surgical site infections (SSIs) at a European university hospital.


METHODS
Matched case-control study nested in a prospective observational cohort study.


METHODS
Basel University Hospital in Switzerland, where an average of 28,000 surgical procedures are performed per year.


METHODS
All in-hospital occurrences of SSI associated with surgeries performed between January 1, 2000, and December 31, 2001, by the visceral, vascular, and traumatology divisions at Basel University Hospital were prospectively recorded. Each case patient was matched to a control patient by age, procedure code, and National Nosocomial Infection Surveillance System risk index. The case-control pairs were analyzed for differences in cost of hospital care and in provision of specialized care.


RESULTS
A total of 6,283 procedures were performed: 187 SSIs were detected in inpatients, 168 of whom were successfully matched with a control patient. For case patients, the mean additional hospital cost was SwF-19,638 (95% confidence interval [CI], SwF-8,492-SwF-30,784); the mean additional postoperative length of hospital stay was 16.8 days (95% CI, 13-20.6 days); and the mean additional in-hospital duration of antibiotic therapy was 7.4 days (95% CI, 5.1-9.6 days). Differences were primarily attributable to organ space SSIs (n = 76).


CONCLUSIONS
In a European university hospital setting, SSIs are costly and constitute a heavy and potentially preventable burden on both patients and healthcare providers.
Department of General Surgery, University Hospital of Basel, Switzerland.
Walter P
WP
Weber
Marcel
M
Zwahlen
Stefan
S
Reck
Chantal
C
Feder-Mengus
Heidi
H
Misteli
Rachel
R
Rosenthal
Daniel
D
Brandenberger
Daniel
D
Oertli
Andreas F
AF
Widmer
Walter R
WR
Marti
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D003428:Cross Infection / Q000188:drug therapy / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006785:Hospitals, University / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay; D008297:Male; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control; D013557:Switzerland
D000900:Anti-Bacterial Agents