title: Surgical site infections in patients who undergo radical cystectomy: Excess mortality, stay prolongation and hospital cost overruns.
abstract: BACKGROUND
  The aim of this study was to analyze the impact of surgical site infections (SSI) in patients who underwent radical cystectomy, in terms of excess hospital mortality, stay prolongation and cost overruns.
  
  
  METHODS
  A retrospective observational study was conducted on a sample of patients who underwent radical cystectomy as recorded in the basic minimum data sets of 87 Spanish hospitals from 2008-2010.
  
  
  RESULTS
  We studied 4377 patients who underwent radical cystectomy (3904 men and 473 women) of whom 849 (19.4%) experienced an SSI. The patients with SSI were predominantly men, elderly and had a higher prevalence of alcohol-related disorders and more comorbidities. The patients with SSI had significant excess mortality (125.6%), undue stay prolongation (17.8 days) and cost overruns (14,875.70 euros).
  
  
  CONCLUSIONS
  After controlling for demographic variables, hospital type, addiction disorders and comorbidities using multivariate pairing, the onset of SSI in patients who underwent radical cystectomy significantly increased the mortality, stay and cost. Certain preventive measures already established in previous studies could reduce the incidence of SSI and its healthcare and financial impact.
authors.affiliation: Servicio de Anestesiología y Bloque Quirúrgico, Hospital Universitario Virgen Macarena, Sevilla, España. Electronic address: egiliort@gmail.com.
authors.forename: E
authors.initials: E
authors.lastname: Gili-Ortiz
authors.affiliation: Servicio de Anestesiología y Bloque Quirúrgico, Hospital Universitario Virgen Macarena, Sevilla, España.
authors.forename: R
authors.initials: R
authors.lastname: González-Guerrero
authors.affiliation: Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Sevilla, Sevilla, España.
authors.forename: L
authors.initials: L
authors.lastname: Béjar-Prado
authors.affiliation: Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Sevilla, Sevilla, España; Servicio de Medicina Preventiva y Salud Pública, Hospital Universitario Virgen Macarena, Sevilla, España.
authors.forename: J
authors.initials: J
authors.lastname: López-Méndez
authors.affiliation: Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Sevilla, Sevilla, España; Servicio de Medicina Preventiva y Salud Pública, Hospital Universitario Virgen Macarena, Sevilla, España.
authors.forename: G
authors.initials: G
authors.lastname: Ramírez-Ramírez
mesh_terms: D000368:Aged; D019973:Alcohol-Related Disorders / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology; D015897:Comorbidity; D015653:Cystectomy; D048909:Diabetes Complications / Q000453:epidemiology; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology; D012189:Retrospective Studies; D012907:Smoking / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D013530:Surgical Wound Infection / Q000191:economics / Q000401:mortality*; D001749:Urinary Bladder Neoplasms / Q000453:epidemiology / Q000601:surgery
keywords: Cistectomía radical; Costes; Costs; Estancia hospitalaria; Hospital stay; Infección de localización quirúrgica; Mortalidad; Mortality; Radical cystectomy; Surgical site infection