The impact of surgical site infection on hospitalisation, treatment costs, and health-related quality of life after vascular surgery

Totty, Joshua; Moss, Joe William Edward; Barker, Erin; Mealing, Stuart; Posnett, John; Chetter, Ian Clifford; Smith, George Edward

Abstract

Surgical site infections (SSI) substantially increase costs for healthcare providers because of additional treatments and extended patient recovery. The objective of this study was to assess the cost and health‐related quality of life impact of SSI, from the perspective of a large teaching hospital in England. Data were available for 144 participants undergoing clean or clean‐contaminated vascular surgery. SSI development, length of hospital stay, readmission, and antibiotic use were recorded over a 30‐day period. Patient‐reported EQ‐5D scores were obtained at baseline, day 7 and day 30. Linear regressions were used to control for confounding variables. A mean SSI‐associated length of stay of 9.72 days resulted in an additional cost of £3776 per patient (including a mean antibiotic cost of £532). Adjusting for age, smoking status, and procedure type, SSI was associated with a 92% increase in length of stay (P < 0.001). The adjusted episode cost was £3040. SSI reduced patient utility between baseline and day 30 by 0.156 (P = 0.236). Readmission rates were higher with SSI (P = 0.017), and the rate to return to work within 90 days was lower. Therefore, strategies to reduce the risk of surgical site infection for high‐risk vascular patients should be investigated.

Citation

Totty, J., Moss, J. W. E., Barker, E., Mealing, S., Posnett, J., Chetter, I. C., & Smith, G. E. (in press). The impact of surgical site infection on hospitalisation, treatment costs, and health-related quality of life after vascular surgery. International wound journal, https://doi.org/10.1111/iwj.13526

• Journal Article Type: Article
• Acceptance Date: Nov 10, 2020
• Online Publication Date: Dec 16, 2020
• Deposit Date: Nov 18, 2020
• Publicly Available Date: Dec 17, 2020
• Journal: International Wound Journal
• Print ISSN: 1742-4801
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1111/iwj.13526
• Keywords: Cost; Health‐related quality of life; Infection; Regression; Vascular surgery
• Public URL: https://hull-repository.worktribe.com/output/3663936
• Publisher URL: https://onlinelibrary.wiley.com/doi/10.1111/iwj.13526