The economic benefits of surgical site infection prevention in adults: a systematic review

Abstract

Background: Surgical site infections (SSI) present a significant burden to healthcare and patients in terms of excess length of stay, distress, disability and death. SSI risk and the associated economic burden may be reduced through adherence to prevention guidelines although the irreducible minimum is unclear.Aim: To evaluate the methods used to estimate the cost effectiveness of prevention strategies for all SSI.Methods: Pubmed, Medline, CINAHL and NHS Economic Evaluation Database were searched from inception to January 2020 to identify English language economic evaluation studies, embedded economic evaluations and studies with some analysis in relation to cost and benefit in adult patients receiving surgical care in any setting. Risk of bias was assessed using the Drummond [1] and Philips [2] checklists.Findings: 32 studies involving 24 043 participants were included. Most studies evaluated SSI prevention in orthopaedic surgeries. Antibiotic prophylaxis, screening, treating or decolonisation of MRSA and surgical wound closure were the main methods evaluated. Methods ranged from cost analyses to cost effectiveness and cost utility analyses. Synthesis of results was not possible due to heterogeneity. All studies reported some economic benefit associated with preventing SSI however measures of benefit were not reported consistently and the quality of studies was low to moderate. Limited evidence in relation to SSI impact on quality of life was identified.Conclusion: Current evidence in relation to the economic benefits of SSI prevention is limited. Further robust studies which utilise sound economic and epidemiological methods are required to inform future investment decisions in SSI prevention.

Cost-effectiveness analysis of an active 30-day surgical site infection surveillance at a tertiary hospital in Ghana: evidence from HAI-Ghana study

“…Therefore, further studies may help conclude on its effectiveness and provide current evidence to improve the lack of studies on economic benefits of SSI interventions in LIMC. 28 CONCLUSION SSI is preventable if an effective intervention is in place. This paper presents an SSI intervention that is adaptable, cost-effective and sustainable within resource-limited settings.…”

“…Therefore, further studies may help conclude on its effectiveness and provide current evidence to improve the lack of studies on economic benefits of SSI interventions in LIMC. 28 …”

Surgical Wound Infections

“…26,[28][29][30] SSIs remain a significant burden, resulting in increased morbidity and mortality, extended postoperative recovery, increased use of health care resources, and cost of approximately $20,785 per case in the United States. 27,31,32 The importance of prevention of SSIs is reflected in the ongoing research and the updated guidelines by 4 major organizations over the past several years: the World Health Organization (WHO), CDC, American College of Surgeons (ACS), and Surgical Infection Society (SIS). [32][33][34] Table 5 summarizes the strongest recommendations across recently published guidelines and literature.…”

Machine learning application for prediction of surgical site infection after posterior cervical surgery

“…Surgical site infection (SSI) is a known and serious postoperative complication following cervical spine surgery 1 . Including spinal surgery, SSI is associated with increased patient morbidity and mortality, healthcare expenses due to readmission and reoperation, and poor prognosis 2,3 . Identifying risk factors for SSI will help develop interventions to reduce the incidence of these infections.…”