Register-based surveillance of COVID-19 in nursing homes. / Registerbasert overvåkning av covid-19 i sykehjem.

BACKGROUND: This study describes results from the surveillance of COVID-19 infections in nursing homes in the first year of the COVID-19 pandemic. MATERIAL AND METHOD: All data in the study are from Beredt C19, an emergency preparedness register that collects data from a wide range of sources. We used the data set 'Health and Care' in the Norwegian Registry for Primary Health Care to define a nursing home population and linked this to other sources in the emergency preparedness register to estimate incidence rates, hospitalisations and deaths related to COVID-19 among nursing home residents in 2020. A log-binomial regression model was used to analyse the risk of death related to COVID-19. RESULTS: Of the 83 114 persons who were included in the study, 35 758 (43 %) were older than 80 years. We found that 570 persons (0.69 %) tested positive for SARS-CoV-2 in 2020. A total of 19 041 residents died during the study period, whereof 248 (1.3 %) deaths were related to COVID-19. The relative risk of dying from COVID-19 rose with age and was highest for long-term nursing home residents. INTERPRETATION: Nursing home residents have a high background mortality, so despite the high lethality of SARS-CoV-2 infection and the high proportion of the COVID-19-related deaths that have occurred in nursing homes, COVID-19-related deaths accounted for a relatively minor proportion of all deaths among nursing home residents.

Infeksjon i operasjonsområdet.

BACKGROUND: All Norwegian hospitals must submit data to the Norwegian Surveillance System for Antibiotic Consumption and Healthcare-Associated Infections (NOIS) regarding surgical site infections following coronary artery bypass graft, caesarean section, hip arthroplasty, cholecystectomy and colonic surgery. The purpose of our study was to identify the proportion of patients undergoing surgery in 2016 who developed a surgical site infection, and the consequences in the form of prolonged postoperative hospitalisation, readmission or revision surgery. MATERIAL AND METHOD: All patients who underwent one of the five surgical procedures registered in NOIS in 2016 were included and followed up for 30 days after the surgery. The criteria set out by the European Centre for Disease Prevention and Control were used to define infections. RESULTS: From among the 31 401 patients included, a total of 1 225 surgical site infections were recorded. The incidence was highest following colonic surgery (10.9 %) and lowest following total hip arthroplasty (1.8 %). Median postoperative length of hospitalisation was three days for those with no infection, and six days for the 544 patients with a deep infection or an infection in an organ or cavity. The infections resulted in the need for revision surgery in 308 patients and readmission for 323 patients. INTERPRETATION: A total of 3.9 % of patients registered with a surgical procedure included in NOIS developed a surgical site infection. Consequences such as increased hospitalisation time, and more readmissions as well as revision procedures serve to highlight the importance of preventing such infections.

National surveillance of surgical site infections after coronary artery bypass grafting in Norway: incidence and risk factors.

OBJECTIVE: A mandatory national surveillance system for surgical site infections (SSIs) following certain surgical procedures, including coronary artery bypass grafting (CABG), was introduced in Norway in 2005. The objectives of this study were to measure national baseline incidence rates of SSIs after CABG, describe the characteristics of the patients and procedures, and identify possible risk factors for infection. METHODS: In 2005-2009, all hospitals that performed CABG were invited to assess all patients undergoing CABG surgery in 3-month periods for SSIs. The hospitals evaluated infection status at discharge and 30 days after surgery by sending post-discharge questionnaires to all patients. We calculated incidence proportions and risk ratios for different risk factors. We applied the National Nosocomial Infection Surveillance (NNIS) risk index to the data. RESULTS: In total, 2440 patients were included. Altogether, 124 sternal and 217 harvest site infections were registered, giving incidence proportions of 5.1% and 8.9%, respectively. Over 95% of infections occurred post-discharge from the hospital. No risk factors were identified. Incidence did not significantly increase with higher NNIS risk index; however, 93% of the patients fell into the same risk category. CONCLUSIONS: We have provided a baseline rate for SSIs after CABG procedures in Norway. The results show the importance of post-hospital discharge follow-up. The NNIS risk index did not adequately stratify CABG patients. We recommend that more potential risk variables should be included in the surveillance, such as the European System for Cardiac Operative Risk Evaluation (EuroSCORE), height, weight, and diabetes.