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Trends in the Incidence of Surgical Site Infection in The Netherlands

Published online by Cambridge University Press:  02 January 2015

Judith Manniën ,
Susan van den Hof ,
Jan Muilwijk ,
Peterhans J. van den Broek ,
Birgit van Benthem  and
Jan C. Wille
Judith Manniën*
Affiliation:
Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
Susan van den Hof
Affiliation:
KNCV Tuberculosis Foundation, The Hague, The Netherlands
Jan Muilwijk
Affiliation:
Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
Peterhans J. van den Broek
Affiliation:
Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
Birgit van Benthem
Affiliation:
Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
Jan C. Wille
Affiliation:
Dutch Institute for Healthcare Improvement (CBO), Utrecht, The Netherlands
*
National Institute for Public Health and the Environment (RIVM), Postbak 75, PO Box 1, 3720 BA Bilthoven, The Netherlands ([email protected])
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Abstract

Objective.

To evaluate the time trend in the surgical site infection (SSI) rate in relation to the duration of surveillance in The Netherlands.

Setting.

Forty-two hospitals that participated in the the Dutch national nosocomial surveillance network, which is known as PREZIES (Preventie van Ziekenhuisinfecties door Surveillance), and that registered at least 1 of the following 5 frequently performed surgical procedures for at least 3 years during the period from 1996 through 2006: mastectomy, colectomy, replacement of the head of the femur, total hip arthroplasty, or knee arthroplasty.

Methods.

Analyses were performed for each surgical procedure. The surveillance time to operation was stratified in consecutive 1-year periods, with the first year as reference. Multivariate logistic regression analysis was performed using a random coefficient model to adjust for random variation among hospitals. All models were adjusted for method of postdischarge surveillance.

Results.

The number of procedures varied from 3,031 for colectomy to 31,407 for total hip arthroplasty, and the SSI rate varied from 1.6% for knee arthroplasty to 12.2% for colectomy. For total hip arthroplasty, the SSI rate decreased significantly by 6% per year of surveillance (odds ratio [OR], 0.94 [95% confidence interval {CI}, 0.90–0.98]), indicating a 60% decrease after 10 years. Nonsignificant but substantial decreasing trends in the rate of SSI were found for replacement of the head of the femur (OR, 0.94 [95% CI, 0.88–1.00]) and for colectomy (OR, 0.92 [95% CI, 0.83–1.02]).

Conclusions.

Even though most decreasing trends in the SSI rate were not statistically significant, they were encouraging. To use limited resources as efficiently as possible, we would suggest switching the surveillance to another surgical procedure when the SSI rate for that particular procedure has decreased below the target rate.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 29 , Issue 12 , December 2008 , pp. 1132 - 1138
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2008

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