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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

Authors

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Mr Josh Totty J.Totty@hull.ac.uk
NIHR Clinical Lecturer in Plastic Surgery

Joe William Edward Moss

Erin Barker

Stuart Mealing

John Posnett



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
Electronic ISSN 1742-481X
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

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http://creativecommons.org/licenses/by-nc/4.0

Copyright Statement
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in anymedium, provided the original work is properly cited an d is not used for commercial purposes.© 2020 The Authors.





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