title: Length of stay and cost for surgical site infection after abdominal and cardiac surgery in Japanese hospitals: multi-center surveillance.
abstract: OBJECTIVE
  This study evaluated the influence of surgical site infections (SSIs) after abdominal or cardiac surgery on the post-operative duration of hospitalization and cost.
  
  
  METHODS
  A retrospective 1:1 matched case-control study of length of stay and healthcare expenditures for patients who were discharged from nine hospitals, between April 1, 2006 and March 31, 2008, after undergoing abdominal or cardiac surgery and who did and did not have a SSI.
  
  
  RESULTS
  Information was obtained from 246 pairs of patients who had undergone abdominal surgery and 27 pairs of patients who had undergone cardiac surgery. Overall, the mean post-operative hospitalization was 20.7 days longer and the mean post-operative healthcare expenditure was $8,791 higher in the SSI group than for the SSI-free group. Among the patients who had undergone abdominal surgery, development of SSI extended the average hospitalization by 17.6 days and increased the average healthcare expenditure by $6,624. Among the patients who had undergone cardiac surgery, SSI extended the post-operative hospitalization by an average of 48.9 days and increased the post-operative healthcare expenditure by an average of $28,534.
  
  
  CONCLUSIONS
  Under the current healthcare system in Japan, the development of SSI after abdominal surgery necessitates extension of hospitalization two-fold and increases the post-operative healthcare expenditure 2.5-fold. Development of SSI after cardiac surgery necessitates extension of hospitalization fourfold and increases the healthcare expenditure six-fold.
authors.affiliation: Department of Surgery, Ohashi Hospital, Toho University Medical Center, Tokyo, Japan. kusachi@med.toho-u.ac.jp
authors.forename: Shinya
authors.initials: S
authors.lastname: Kusachi
authors.forename: Nobuichi
authors.initials: N
authors.lastname: Kashimura
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: Junjiro
authors.initials: J
authors.lastname: Kobayashi
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Sawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Imoto
authors.forename: Noboru
authors.initials: N
authors.lastname: Motomura
authors.forename: Haruo
authors.initials: H
authors.lastname: Makuuchi
authors.forename: Kazuo
authors.initials: K
authors.lastname: Tanemoto
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Sumiyama
mesh_terms: D000368:Aged; D006348:Cardiac Surgical Procedures / Q000191:economics* / Q000706:statistics & numerical data; D013505:Digestive System Surgical Procedures / Q000191:economics* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007902:Length of Stay / Q000191:economics* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013530:Surgical Wound Infection / Q000191:economics* / Q000453:epidemiology