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Total cost of surgical site infection in the two years following primary knee replacement surgery

Published online by Cambridge University Press:  28 May 2020

Lynn N. Lethbridge Open the ORCID record for Lynn N. Lethbridge [Opens in a new window] ,
C. Glen Richardson  and
Michael J. Dunbar
Lynn N. Lethbridge*
Affiliation:
Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
C. Glen Richardson
Affiliation:
Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
Michael J. Dunbar
Affiliation:
Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
*
Author for correspondence: Lynn N. Lethbridge, E-mail: Lynn.Lethbridge@dal.ca
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Abstract

Objective:

The disease burden of surgical site infection (SSI) following total knee (TKA) replacement is considerable and is expected to grow with increased demand for the procedure. Diagnosing and treating SSI utilizes both inpatient and outpatient services, and the timing of diagnosis can affect health service requirements. The purpose of this study was to estimate the health system costs of infection and to compare them across time-to-diagnosis categories.

Methods:

Administrative data from 2005–2016 were used to identify cases diagnosed with SSI up to 1 year following primary TKA. Uninfected controls were selected matched on age, sex and comorbidities. Costs and utilization were measured over the 2-year period following surgery using hospital and out-of-hospital data. Costs and utilization were compared for those diagnosed within 30, 90, 180, and 365 days. A subsample of cases and controls without comorbidities were also compared.

Results:

We identified 238 SSI cases over the study period. On average, SSI cases cost 8 times more than noninfected controls over the 2-year follow-up period (CaD$41,938 [US$29,965] vs CaD$5,158 [US$3,685]) for a net difference of CaD$36,780 (US$26,279). The case-to-control ratio for costs was lowest for those diagnosed within 30 days compared to those diagnosed later. When only patients without comorbidities were included, costs were >7 times higher.

Conclusion:

Our results suggest that considerable costs result from SSI following TKA and that those costs vary depending on the time of diagnosis. A 2-year follow-up period provided a more complete estimate of cost and utilization.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 41 , Issue 8 , August 2020 , pp. 938 - 942
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Copyright
© 2020 by The Society for Healthcare Epidemiology of America. All rights reserved.

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Footnotes

PREVIOUS PRESENTATION: A version of this work was accepted and presented at the 2018 International Population Data Linkage Conference, September 12–14, 2018, in Banff, Alberta, Canada.

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