Hip prosthesis and colon surgery, a decade of surveillance on surgical site infections in Italy, a prospective cohort study: rates, trends, and disease burden in DALYs.

IF 4.8 2区 医学 Q1 INFECTIOUS DISEASES
Valerio Bordino, Costanza Vicentini, Alessandro Roberto Cornio, Maria Michela Gianino, Carla Maria Zotti
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引用次数: 0

Abstract

Background: Surveillance programs are a key element of interventions aiming to reduce rates of surgical site infections (SSIs). The aim of this study was to evaluate rates and trends of SSIs following hip arthroplasty and colon surgery procedures in Piedmont, a region in North-western Italy, from 2010 to 2019. Further, we aimed to assess the burden of SSIs in terms of Disability-Adjusted Life-Years (DALYs).

Methods: A prospective cohort study was conducted among 42 hospitals participating in the surveillance system. Procedure-specific SSI rates were calculated and the 2010 - 2019 trend was evaluated using Spearman's Rho test. Patients were stratified according to age, sex and infection risk index according to life expectancy in order to calculate DALYs, using a modified version of the ECDC's BCoDE toolkit: disease models for both procedure types were adapted to incorporate long-term disability associated with SSIs.

Results: Overall, 20,356 hip arthroplasty and 11,011 colon surgery procedures were monitored over 10 years and were included in our analyses. Hip arthroplasty and colon surgery cumulative SSIs rates were 1.5% and 8% respectively. Using the Spearman's Rho test, we evaluated a significant downward trend from 2010 to 2019 for colon surgery interventions (Rs - 0.7, p < 0.05), while there was no difference for hip arthroplasty. (Rs - 0.04, p > 0.05). Regarding disease burden, a total of 955.3 (95%CI 837.7-1102.98) and 208.65 (95%CI 180.87-240.90) DALYs were calculated for SSIs following hip arthroplasty, whilst 76.58 (95%CI 67.15-90.71) and 38.62 (95% CI 33.09-45.36) DALYs for SSIs in colon surgery, in 2010 and 2019, respectively.

Conclusions: The significant decrease both in terms of incidence and DALYs found in this study for colon surgery and the stability for hip arthroplasty support the role of surveillance networks in improving quality of care. Despite the smaller SSI rate, the burden associated with SSIs following hip arthroplasty was higher, which is important to consider in light of the aging population in Italy.

髋关节假体和结肠手术,十年来对意大利手术部位感染的监控,一项前瞻性队列研究:以 DALYs 为单位的发病率、趋势和疾病负担。
背景:监测计划是旨在降低手术部位感染(SSI)率的干预措施的关键要素。本研究旨在评估 2010 年至 2019 年意大利西北部皮埃蒙特大区髋关节置换术和结肠手术后 SSI 的发生率和趋势。此外,我们还旨在从残疾调整寿命年数(DALYs)的角度评估 SSI 带来的负担:方法:在参与监控系统的 42 家医院中开展了一项前瞻性队列研究。计算了特定手术的 SSI 感染率,并使用 Spearman's Rho 检验评估了 2010 - 2019 年的趋势。根据患者的年龄、性别和预期寿命的感染风险指数对患者进行分层,以计算残疾调整寿命年数(DALYs),使用的是欧洲疾病控制中心 BCoDE 工具包的改进版:对两种手术类型的疾病模型进行了调整,以纳入与 SSI 相关的长期残疾:总体而言,我们在 10 年内对 20,356 例髋关节置换术和 11,011 例结肠手术进行了监测,并将其纳入分析。髋关节置换术和结肠手术的累积 SSI 感染率分别为 1.5% 和 8%。通过斯皮尔曼 Rho 检验,我们发现从 2010 年到 2019 年,结肠手术介入率呈显著下降趋势(Rs - 0.7,P 0.05)。在疾病负担方面,2010 年和 2019 年,髋关节置换术后的 SSI 计算出的残疾调整寿命年数分别为 955.3 (95%CI 837.7-1102.98) 和 208.65 (95%CI 180.87-240.90) 年,而结肠手术 SSI 计算出的残疾调整寿命年数分别为 76.58 (95%CI 67.15-90.71) 和 38.62 (95%CI 33.09-45.36) 年:本研究发现,结肠手术的 SSI 发生率和残疾调整寿命年数均大幅下降,而髋关节置换术的 SSI 发生率则保持稳定,这证明了监督网络在提高医疗质量方面的作用。尽管 SSI 发生率较低,但髋关节置换术后 SSI 带来的负担却较高,鉴于意大利人口老龄化,这一点很重要。
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来源期刊
Antimicrobial Resistance and Infection Control
Antimicrobial Resistance and Infection Control PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES
CiteScore
9.70
自引率
3.60%
发文量
140
审稿时长
13 weeks
期刊介绍: Antimicrobial Resistance and Infection Control is a global forum for all those working on the prevention, diagnostic and treatment of health-care associated infections and antimicrobial resistance development in all health-care settings. The journal covers a broad spectrum of preeminent practices and best available data to the top interventional and translational research, and innovative developments in the field of infection control.
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