Comparison of Cost Savings of Methods of Prevention of Orthopedic Implant-Associated Infection in Arthroplasty and Closed Fracture Surgery Patients.

IF 4.6 2区医学 Q1 INFECTIOUS DISEASES

Antibiotics-Basel Pub Date : 2025-09-05 DOI:10.3390/antibiotics14090900

Pedro Augusto Maciel Moreira, Thiago de Carvalho Gontijo, Gabriel Costa Colen, Ana Carolina Morganti, Felipe Ismael Ulloa Gómez, Pedro Assis Mourão, Gabrielle Adriane Rodrigues Mota, Braulio R G M Couto, Patrícia Almeida de Vasconcellos Rocha, Laila Gonçalves Machado, Raquel Bandeira da Silva, Mauro José Salles

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引用次数: 0

Abstract

Background/Objectives: Surgical site infections (SSIs) are serious complications in orthopedic implant-associated procedures, increasing morbidity, mortality, and hospital costs. The purpose of this study was to evaluate the impact of a structured infection prevention and control (IPC) service on SSI incidence and cost savings across hip arthroplasty (HA), knee arthroplasty (KA), and open reduction and internal fixation (ORIF). Methods: A retrospective analysis included 6930 patients treated between 2019 and 2024, divided into pre-intervention (2019-2022) and post-intervention (2023-2024) cohorts. Preventive methods (PMs) comprised enhanced antibiotic prophylaxis, Staphylococcus aureus screening, chlorhexidine bathing, intraoperative audits, and behavioral interventions. Economic evaluation used literature-based costs, standardized to 2024 US dollars (USD 2024), with sensitivity analyses performed. Results: SSI incidence decreased from 5.6% to 1.1% overall (p < 0.001), with consistent reductions across procedures: ORIF (5.2%→1.0%), HA (9.2%→2.4%), and KA (4.8%→1.2%). In 2023, approximately 31 SSIs and one infection-related death were prevented, avoiding 308 hospital days. Cost savings ranged from USD 209,188 to USD 376,898, with cost saving confirmed in 93% of simulations. Conclusions: Comprehensive infection-prevention protocols, delivered through a structured IPC service, significantly reduced SSIs and generated substantial cost savings. These findings support wider use of these PMs in orthopedic surgery.

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预防关节置换术和闭合性骨折患者植入物相关感染的方法节约成本的比较。

背景/目的：手术部位感染（ssi）是骨科植入物相关手术的严重并发症，增加了发病率、死亡率和住院费用。本研究的目的是评估结构化感染预防和控制（IPC）服务对髋关节置换术（HA）、膝关节置换术（KA）和切开复位内固定（ORIF）中SSI发生率和成本节约的影响。方法：回顾性分析2019- 2024年间6930例患者，分为干预前（2019-2022）和干预后（2023-2024）两组。预防方法包括加强抗生素预防、金黄色葡萄球菌筛查、洗必泰沐浴、术中审计和行为干预。经济评估采用基于文献的成本，标准化为2024美元（USD 2024），并进行敏感性分析。结果：SSI发生率从5.6%总体下降到1.1% (p < 0.001)，各手术均有一致的降低：ORIF（5.2%→1.0%）、HA（9.2%→2.4%）和KA（4.8%→1.2%）。2023年，预防了大约31例ssi和1例感染相关死亡，避免了308个住院日。成本节约从209,188美元到376,898美元不等，93%的模拟结果证实了成本节约。结论：通过结构化IPC服务提供的综合感染预防方案显著降低了ssi，并节省了大量成本。这些发现支持在骨科手术中更广泛地使用这些pm。

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来源期刊

Antibiotics-Basel Pharmacology, Toxicology and Pharmaceutics-General Pharmacology, Toxicology and Pharmaceutics

CiteScore

7.30

自引率

14.60%

发文量

1547

审稿时长

11 weeks

期刊介绍： Antibiotics (ISSN 2079-6382) is an open access, peer reviewed journal on all aspects of antibiotics. Antibiotics is a multi-disciplinary journal encompassing the general fields of biochemistry, chemistry, genetics, microbiology and pharmacology. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. Therefore, there is no restriction on the length of papers.