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Surgical site infection reporting: more than meets the agar.
Putnam, Luke R; Ostovar-Kermani, Tiffany G; Le Blanc, Andrea; Anderson, Kathryn T; Holzmann-Pazgal, Galit; Lally, Kevin P; Tsao, KuoJen.
Afiliação
  • Putnam LR; Center for Surgical Trials and Evidence-based Practice, Department of Pediatric Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston, TX; Children's Memorial Hermann Hospital, Houston, TX.
  • Ostovar-Kermani TG; Center for Surgical Trials and Evidence-based Practice, Department of Pediatric Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston, TX; Children's Memorial Hermann Hospital, Houston, TX.
  • Le Blanc A; Children's Memorial Hermann Hospital, Houston, TX; Department of Infectious Diseases, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX.
  • Anderson KT; Center for Surgical Trials and Evidence-based Practice, Department of Pediatric Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston, TX; Children's Memorial Hermann Hospital, Houston, TX.
  • Holzmann-Pazgal G; Children's Memorial Hermann Hospital, Houston, TX; Department of Infectious Diseases, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX.
  • Lally KP; Center for Surgical Trials and Evidence-based Practice, Department of Pediatric Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston, TX; Children's Memorial Hermann Hospital, Houston, TX.
  • Tsao K; Center for Surgical Trials and Evidence-based Practice, Department of Pediatric Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston, TX; Children's Memorial Hermann Hospital, Houston, TX. Electronic address: kuojen.tsao@uth.tmc.edu.
J Pediatr Surg ; 52(1): 156-160, 2017 Jan.
Article em En | MEDLINE | ID: mdl-27863822
BACKGROUND/PURPOSE: Surgical site infection (SSI) rate in pediatric appendicitis is a commonly used hospital quality metric. We hypothesized that surveillance of organ-space SSI (OSI) using cultures alone would fail to capture many clinically-important events. METHODS: A prospective, multidisciplinary surveillance program recorded 30-day SSI and hospital length of stay (LOS) for patients <18years undergoing appendectomy for perforated appendicitis from 2012 to 2015. Standardized treatment pathways were utilized, and OSI was identified by imaging and/or bacterial cultures. RESULTS: Four hundred ten appendectomies for perforated appendicitis were performed, and a total of 84 OSIs (20.5%) were diagnosed with imaging. Positive cultures were obtained for 39 (46%) OSIs, whereas 45 (54%) had imaging only. Compared to the mean LOS for patients without OSI (5.2±2.9days), LOS for patients with OSI and positive cultures (13.7±5.4days) or with OSI without cultures (10.4±3.7days) was significantly longer (both p<0.001). The OSI rate identified by positive cultures alone was 9.5%, whereas the clinically-relevant OSI rate was 20.5%. CONCLUSIONS: Using positive cultures alone to capture OSI would have identified less than half of clinically-important infections. Utilizing clinically-relevant SSI is an appropriate metric for comparing hospital quality but requires agreed upon standards for diagnosis and reporting. LEVEL OF EVIDENCE: II. TYPE OF STUDY: Diagnostic study.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Apendicectomia / Apendicite / Infecção da Ferida Cirúrgica Tipo de estudo: Diagnostic_studies / Etiology_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Child / Female / Humans / Male País como assunto: America do norte Idioma: En Ano de publicação: 2017 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Apendicectomia / Apendicite / Infecção da Ferida Cirúrgica Tipo de estudo: Diagnostic_studies / Etiology_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Child / Female / Humans / Male País como assunto: America do norte Idioma: En Ano de publicação: 2017 Tipo de documento: Article