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Hospital-Related Determinants For Surgical-Site Infection Following Hip Arthroplasty

Published online by Cambridge University Press:  21 June 2016

Eveline L. P. E. Geubbels ,
Jan C. Wille ,
Nico J. D. Nagelkerke ,
Christina M. J. E. Vandenbroucke-Grauls ,
Diederick E. Grobbee  and
Annette S. de Boer
Eveline L. P. E. Geubbels
Affiliation:
Department of Infectious Diseases Epidemiology, National Institute of Public Health and the Environment (RIVM), Bilthoven, the Netherlands
Jan C. Wille*
Affiliation:
Dutch Institute for Healthcare Improvement CBO, Utrecht, the Netherlands
Nico J. D. Nagelkerke
Affiliation:
Department of Computerization and Methodological Consultancy, National Institute of Public Health and the Environment (RIVM), Bilthoven, the Netherlands
Christina M. J. E. Vandenbroucke-Grauls
Affiliation:
Department of Medical Microbiology and Infection Control, Vrije Universiteit Medical Center, Amsterdam, the Netherlands
Diederick E. Grobbee
Affiliation:
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
Annette S. de Boer
Affiliation:
Department of Infectious Diseases Epidemiology, National Institute of Public Health and the Environment (RIVM), Bilthoven, the Netherlands
*
Dutch Institute for Healthcare Improvement CBO, PO Box 20064, 3502 LB, Utrecht, the Netherlands. j.uiille@cbo.nl
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Abstract

Objective:

To determine hospital-related risk factors for surgical-site infection (SSI) following hip arthroplasty.

Design:

Prospective, multicenter cohort study based on surveillance data and data collected through a structured telephone interview. With the use of multilevel logistic regression, the independent effect of hospital-related characteristics on SSI was assessed.

Setting:

Thirty-six acute care hospitals in the Dutch surveillance network for nosocomial infections (PREZIES), from 1996 to 2000.

Patients:

Thirteen thousand six hundred eighty patients who underwent total or partial hip arthroplasty.

Results:

A high annual volume of operations was associated with a reduced risk of SSI (risk-adjusted risk ratio [RR] per 50 extra operations, 0.85; 95% confidence interval [CI95], 0.74–0.97). With each extra full-time–equivalent infection control staff member per 250 beds available for prevention of SSI, the risk for SSI was decreased (RR, 0.48; CI95, 0.16–1.44), although the decrease was not statistically significant. Hospital size, teaching status, university affiliation, and number of surgeons and their years of experience showed no important association with the risk of SSI.

Conclusion:

Undergoing surgery in a hospital with a low volume of operations increases a patient's risk of SSI.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 26 , Issue 5 , May 2005 , pp. 435 - 441
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2005

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