Surgical site infections in outpatient surgeries: Less invasive procedures contribute substantially to the overall burden

Abstract

More than 50% of outpatient surgeries predicted to have an increased likelihood of an adverse event were excluded from surgical site infection (SSI) surveillance based on Veterans Affairs Surgical Quality Improvement Program (VASQIP) eligibility criteria, defined by clinician determination of invasiveness. Burden of SSI for eligible versus ineligible surgeries was similar; thus, surveillance activities in the outpatient setting need to be re-evaluated.

What is the role of selection bias in quality comparisons between the Veterans Health Administration and community care? Example of elective hernia surgery

“…We included diagnosis codes from encounters in the VHA or CC based on a previously developed set of International Classification of Diseases ICD‐10‐CM diagnosis codes (see File S3). 25 These codes were adapted from ones originally intended to identify surgical complications from inpatient care during readmissions and have been used in prior work on prevalent outpatient surgical adverse events 17,26,27 . Our final list of complications included wound‐related problems, bleeding, sepsis, and urinary tract infection.…”

“…25 These codes were adapted from ones originally intended to identify surgical complications from inpatient care during readmissions and have been used in prior work on prevalent outpatient surgical adverse events. 17,26,27 Our final list of complications included wound-related problems, bleeding, sepsis, and urinary tract infection. These complications are also tracked by other validated quality and safety metrics like the Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators and the National Surgical Quality Improvement Program.…”