title: Impact of surgical site infection after colorectal surgery on hospital stay and medical expenditure in Japan.
abstract: OBJECTIVE
  To clarify the impact of surgical site infection (SSI) after colorectal surgery on the length of hospital stay and medical expenditure in Japan.
  
  
  METHODS
  This was a multi-center, retrospective-matched case-control study.
  
  
  RESULTS
  The total number of patients enrolled was 334 (167 case/control pairs). The average hospital stay after surgery was prolonged by 17.8 days (95% CI 11.9-23.5) and the average medical cost after surgery was increased by $5,938 (95% CI 3,610-8,367) in the SSI group versus the non-SSI group. Hospital charges comprised the largest among all cost categories and accounted for 53% of the additional cost. The hospital stay and medical costs both increased proportionately to the depth of the SSI, from 4.4 days and $608 for superficial incisional SSI, to 39.2 days and $14,448 for organ/space SSI. SSI caused by MRSA prolonged the hospital stay by 19.3 days and incurred an additional cost of $7,015.
  
  
  CONCLUSIONS
  SSI clearly prolonged the hospital stay and increased medical costs. The numerical values revealed by this study reinforce the medical-economic importance of instigating preventive measures against SSI.
authors.affiliation: Department of Surgery, Teine Keijinkai Hospital, 1-12 Maeda Teine-ku, Sapporo 006-8555, Japan. nkashimura@keijinkai.or.jp
authors.forename: Nobuichi
authors.initials: N
authors.lastname: Kashimura
authors.forename: Shinya
authors.initials: S
authors.lastname: Kusachi
authors.forename: Toshiro
authors.initials: T
authors.lastname: Konishi
authors.forename: Junzo
authors.initials: J
authors.lastname: Shimizu
authors.forename: Masato
authors.initials: M
authors.lastname: Kusunoki
authors.forename: Masaaki
authors.initials: M
authors.lastname: Oka
authors.forename: Toshiro
authors.initials: T
authors.lastname: Wakatsuki
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Sumiyama
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D003106:Colon / Q000601:surgery*; D017722:Hospital Charges; D006801:Humans; D007564:Japan; D010535:Laparoscopy; D007902:Length of Stay / Q000191:economics*; D055624:Methicillin-Resistant Staphylococcus aureus; D012007:Rectum / Q000601:surgery*; D012086:Reoperation / Q000191:economics; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000191:economics; D013530:Surgical Wound Infection / Q000191:economics* / Q000382:microbiology