The impact of surgical site infection on hospitalisation, treatment costs, and health‐related quality of life after vascular surgery

Totty, Joshua; Moss, Joe; Barker, Erin; Mealing, Stuart; Posnett, John; Chetter, Ian; Smith, George E.

doi:10.1111/iwj.13526

Cited by 44 publications

(33 citation statements)

References 24 publications

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“…For example, Lissovoy [ 11 ] estimated that the cost of SSIs was USD 20,842 per patient for all surgical categories. However, the analysis of costs secondary to SSIs must be stratified by procedure type as both infection rates and durations of hospital stay vary depending on the surgical procedure considered [ 24 , 25 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

Estimated Costs Associated with Surgical Site Infections in Patients Undergoing Cholecystectomy

Algado-Sellés

Mira-Bernabeu

Gras-Valentí

et al. 2022

IJERPH

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Among healthcare-associated infections, surgical site infections (SSIs) are the most frequent in Spain. The aim of this work was to estimate the costs of SSIs in patients who underwent a cholecystectomy at the Hospital General Universitario de Alicante (Spain) between 2012–2017. This was a prospective observational cohort study. The Active Epidemiological Surveillance Program at our hospital recorded all the cholecystectomies performed. Risk factors associated with the development of SSIs were determined by multivariate analysis and two homogeneous comparison groups were obtained by using the propensity score. The number of extra days of hospital stay were recorded for patients with an SSI and with the cost per hospitalised day data, the additional cost attributed to SSIs was calculated. A total of 2200 cholecystectomies were considered; 110 patients (5.0%) developed an SSI. The average length of hospital stay was 5.6 days longer among patients with an SSI. The cost per SSI was EUR 1890.60 per patient, with the total cost for this period being EUR 207,961.60. SSIs after cholecystectomy lead to a prolongation of hospital stay and an increase in economic costs. It is essential to implement infection surveillance and control programs to reduce SSIs, improve patient safety, and reduce economic burden.

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Section: Discussionmentioning

confidence: 99%

Estimated Costs Associated with Surgical Site Infections in Patients Undergoing Cholecystectomy

Algado-Sellés

Mira-Bernabeu

Gras-Valentí

et al. 2022

IJERPH

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“…This value was calculated using information on the percentage of patients undergoing large bowel surgery who required inpatient services only, and who required inpatient services and readmission (Table 1 ) [ 24 ]. Data from Totty et al were used to inform the mean number of excess hospital days that would be required due to the occurrence of SSI (9.72) [ 9 ], with alternative data from Coello et al explored in scenario analysis [ 35 ]. The monthly subscription price of the Caresyntax platform of £4407.00 was obtained from the Caresyntax Corporation and was used in the base-case analysis [ 16 ].…”

Section: Methodsmentioning

confidence: 99%

“…The cost of an NPWT kit was calculated based on information from NICE MTG43 (£130.00) [ 26 ], with an assumption that an additional 10.00% of patients would require a replacement NPWT. The cost of an additional hospitalization day due to SSI was calculated at £375.43, with the mean antibiotic cost calculated at £598.43, based on data from Totty et al [ 9 ]. Finally, the cost of a readmission episode was estimated at £5740.00, based on data from the NHS Reference Costs 2020–2021 [ 27 ].…”

Section: Methodsmentioning

confidence: 99%

“…Totty et al explored the impact of SSIs on hospitalization rates, treatment costs, and patient health-related quality of life (HRQoL) following vascular surgery, based on data from 144 patients at a large teaching hospital in England. Their study showed that SSIs were associated with 9.72 days’ length of stay in hospital (92% increase in length of stay [ p < 0.001]), with an additional cost of £3776.00 per patient (including a mean antibiotic cost of £532.00), with increased readmission rates due to SSI ( p = 0.017) [ 9 ]. At a population level, SSIs are estimated to cost the National Health Service (NHS) in the UK approximately £700 million per annum [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Cost-Utility Analysis of the Caresyntax Platform to Identify Patients at Risk of Surgical Site Infection Undergoing Colorectal Surgery

Moloney

Mashayekhi

Javanbakht

et al. 2023

PharmacoEconomics Open

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Background Surgical site infections (SSIs) account for up to 18% of all healthcare-associated infections (HAIs). The Caresyntax data-driven surgery platform incorporates the most common risk factors for SSI, to identify high-risk surgical patients before they leave the operating theatre and treat them prophylactically with negative pressure wound therapy (NPWT). An economic analysis was performed to assess the costs and health outcomes associated with introduction of the technology in the English healthcare setting. Methods A hybrid decision tree/Markov model was developed to reflect the treatment pathways that patients undergoing colorectal surgery would typically follow, both over the short term (30-day hospital setting) and long term (lifetime). The analysis considered implementation of Caresyntax’s platform-based SSI predictive algorithm in the hospital setting, compared with standard of care, from an English National Health Service (NHS) perspective. The base-case analysis presents results in terms of cost per quality-adjusted life-year (QALY) gained, as well as operational impact. Results The base-case analysis indicates that the intervention leads to a cost saving of £55.52m across the total NHS colorectal surgery patient population in 1 year. In addition, the intervention has a 98.36% probability of being cost effective over a lifetime horizon. The intervention results in the avoidance of 19,744 SSI events, as well 191,911 excess hospital bed days saved. Conclusion Caresyntax’s platform-based SSI predictive algorithm has the potential to result in cost savings and improved patient quality of life. Additionally, operational gains for the healthcare provider, including reduced infection rates and hospital bed days saved, have been shown through the economic modeling. Supplementary Information The online version contains supplementary material available at 10.1007/s41669-023-00389-z.

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“…For patients, SSI may have a significant impact on morbidity and mortality with subsequent time and cost implications [ 6 ]. Unsurprisingly, the burden of infection encompasses healthcare providers too, with a recent UK study showing an association of SSI with a 92% increase in length of stay and an adjusted episode cost of £3040 [ 7 ]. Treatment for SSI can range from an oral course of antibiotics, to the need for reintervention (drainage or debridement), prolonged inpatient readmission and the subsequent risk of further morbidity (i.e.…”

Section: Introductionmentioning

confidence: 99%

The diagnostic test accuracy of telemedicine for detection of surgical site infection: A systematic review protocol

et al. 2022

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Since the COVID-19 pandemic there has been a rapid uptake and utilisation of telemedicine in all aspects of healthcare. This presents a key opportunity in surgical site infection surveillance. Remote follow up methods have been used via telephone, with photographs and questionnaires for post-operative reviews with varying results. This review therefore aims to comprehensively synthesise available evidence for the diagnostic accuracy of all forms of SSI telemedicine monitoring. The protocol has been established as per both PRISMA-P (S1 Table) and the Cochrane handbook for reviews of diagnostic test accuracy. Medline, Embase, CENTRAL and CINAHL will be searched using a complete search strategy developed with librarian input, in addition to google scholar and hand searching. All study designs with patients over 18 and undergone a primarily closed surgical procedure will be eligible. Index tests will include all forms of telemedicine and a subgroup analysis performed for each of these. Comparative tests must include face to face review, and all reference standards will be included again for sub-group analyses. Search results will be screened by two investigators independently with a third providing consensus review on disagreements. Methodological quality will be assessed using the QUADAS-2 tool, first validated by two investigators as per the Cochrane handbook. Exploratory analysis will formulate summary receiver operating characteristic curves and forest plots with estimates of sensitivity and specificity of the included studies. Sources of heterogeneity will be identifying and investigated through further analysis. Potential benefits of telemedicine integration in surgical practice will reduce cost and travel time to patients in addition to avoiding wasted clinic appointments, important considerations in a peri-pandemic era. To avoid missed or further complications, there must be confidence in the ability to diagnose infection. This review will systematically determine whether telemedicine is accurate for surgical site infection diagnosis, which methods are well established and if further research is indicated.

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The impact of surgical site infection on hospitalisation, treatment costs, and health‐related quality of life after vascular surgery

Cited by 44 publications

References 24 publications

Estimated Costs Associated with Surgical Site Infections in Patients Undergoing Cholecystectomy

Estimated Costs Associated with Surgical Site Infections in Patients Undergoing Cholecystectomy

Cost-Utility Analysis of the Caresyntax Platform to Identify Patients at Risk of Surgical Site Infection Undergoing Colorectal Surgery

The diagnostic test accuracy of telemedicine for detection of surgical site infection: A systematic review protocol

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