OBJECTIVE:To determine mortality, morbidity, and costs attributable to surgical-site infections (SSIs) in the 1990s.DESIGN: A matched follow-up study of a cohort of patients with SSI, matched one-to-one with patients without SSI.SETTING: A 415-bed community hospital. STUDY POPULATION: 255 pairs of patients with and without SSI were matched on age, procedure, National Nosocomial Infection Surveillance System risk index, date of surgery, and surgeon. OUTCOME MEASURES: Mortality, excess length of hospitalization, and extra direct costs attributable to SSI; relative risk for intensive care unit (ICU) admission and for readmission to the hospital.RESULTS: Of the 255 pairs, 20 infected patients (7.8%) and 9 uninfected patients (3.5%) died during the postoperative hospitalization (relative risk [RR], 2.2; 95% confidence interval [CI 95 ], 1.1-4.5). Seventy-four infected patients (29%) and 46 uninfected patients (18%) required ICU admission (RR, 1.6; CI 95 , 1.3-2.0). The median length of hospitalization was 11 days for infected patients and 6 days for uninfected patients. The extra hospital stay attributable to SSI was 6.5 days (CI 95 , 5-8 days). The median direct costs of hospitalization were $7,531 for infected patients and $3,844 for uninfected patients. The excess direct costs attributable to SSI were $3,089 (CI 95 , $2,139-$4,163). Among the 229 pairs who survived the initial hospitalization, 94 infected patients (41%) and 17 uninfected patients (7%) required readmission to the hospital within 30 days of discharge (RR, 5.5; CI 95 , 4.0-7.7). When the second hospitalization was included, the total excess hospitalization and direct costs attributable to SSI were 12 days and $5,038, respectively.CONCLUSIONS: In the 1990s, patients who develop SSI have longer and costlier hospitalizations than patients who do not develop such infections. They are twice as likely to die, 60% more likely to spend time in an ICU, and more than five times more likely to be readmitted to the hospital. Programs that reduce the incidence of SSI can substantially decrease morbidity and mortality and reduce the economic burden for patients and hospitals (Infect Control Hosp Epidemiol 1999;20:725-730).Each year, more than 18 million surgical procedures are performed in US hospitals. 1 The Centers for Disease Control and Prevention (CDC) estimates that 2.7% of these are complicated by surgical-site infections (SSIs), accounting for at least 486,000 nosocomial infections each year. 2 Such infections often lead to substantial morbidity and probably contribute to mortality in some patients. 3,4 However, the extent of morbidity and mortality attributable to SSI is not known. It is generally accepted that SSIs, like other nosocomial infections, prolong hospital stays and add to the economic costs of hospitalization. However, published estimates of the actual excess days and costs attributable to SSI reflect hospitalization patterns prior to the current era of diagnosis-related groups (DRGs) and managed care. [5][6][7][8][9][10][11] We conducted a ...

Orthopedic SSIs prolong total hospital stays by a median of 2 weeks per patient, approximately double rehospitalization rates, and increase healthcare costs by more than 300%. Moreover, patients with orthopedic SSIs have substantially greater physical limitations and significant reductions in their health-related quality of life.

Patients recognize the inherently unappealing nature of FMT, but they are nonetheless open to considering it as a treatment alternative for recurrent CDI, especially when recommended by a physician.

Maternal Tdap immunization resulted in higher pertussis antibody concentrations during the period between birth and the first vaccine dose. Although slightly decreased immune responses following the primary series were seen compared with controls, differences did not persist following the booster.

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