结直肠手术后手术部位感染：马来西亚一家主要转诊医院的发病率、医疗资源利用和风险因素

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health Pub Date : 2025-09-01 DOI:10.1016/j.cegh.2025.102167

Kenneth Kwing Chin Lee , Jing Sheng Lim , Fitjerald Henry , Mayurran Panirselvam , Cindy Sin Yee Ngiam , Pavithra Malaimany , Julie Angela Aguilar , HyeJin Park , Wei Chern Ang , Wai Yee Choon , Subramaniam Thanimalai , Renukha Sellappans

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引用次数: 0

摘要

手术部位感染（SSI）仍然是一个重要的临床和经济负担，特别是在结直肠手术中。尽管在马来西亚进行了大量的手术，但关于结直肠SSI的发病率、风险因素和成本影响的当地数据有限。本研究旨在通过评估马来西亚公立医院环境中SSI的负担来解决这一差距。方法回顾性队列研究使用马来西亚中部地区结直肠转诊中心的数据，时间为2023年1月1日至2024年6月30日。纳入年龄在18-75岁的住院结直肠手术的成年患者，术后随访30天。使用从电子病历中获得的临床和资源利用数据进行描述性分析。结果研究期间共行125例结直肠手术，42例发生SSI，发生率为33.6%。SSI患者的医疗费用更高，平均指数住院费用为8978令吉（令吉1 = 0.23美元），而非SSI患者的住院费用为6057令吉。SSI组的出院后费用也较高（937令吉vs 341令吉）。可归因于SSI的总直接成本为166,286令吉，主要成本驱动因素是实验室调查（46%）和设施相关成本（30%）。结论结直肠手术中SSI的高发生率和高费用负担突出了加强感染预防的必要性。加强对预防指南的遵守，扩大手术后促进恢复（ERAS）方案的实施，加强监测系统，对于改善结果和降低成本至关重要。

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Surgical site infection following colorectal surgeries: Incidence, healthcare resource utilisation and risk factors in a major referral hospital in Malaysia

Problem considered

Surgical site infections (SSI) remain a significant clinical and economic burden, particularly in colorectal surgeries. Despite the high volume of surgeries performed in Malaysia, there is limited local data on the incidence, risk factors, and cost implications of colorectal SSI. This study aimed to address this gap by evaluating the burden of SSI in a Malaysian public hospital setting.

Methods

A retrospective cohort study was conducted using data from a Malaysian colorectal referral centre for central region, between January 1, 2023, and June 30, 2024. Adult patients aged 18–75 years who underwent inpatient colorectal surgery were included, with 30-day postoperative follow-up. Descriptive analysis was performed using clinical and resource utilisation data obtained from electronic medical records.

Results

A total of 125 colorectal surgeries were performed during the study period, with 42 patients developing SSI, yielding an incidence rate of 33.6 %. Patients with SSI incurred higher healthcare costs, with mean index hospitalisation costs of RM 8978 (RM 1 = 0.23 USD) compared to RM 6057 for those without SSI. Post-discharge costs were also higher in the SSI group (RM 937 vs RM 341). The total direct cost attributable to SSI was RM 166,286, with key cost drivers being laboratory investigations (46 %) and facility-related costs (30 %).

Conclusion

The high incidence and cost burden of SSI in colorectal surgery highlight the need for improved infection prevention. Enhancing adherence to prophylactic guidelines, expanding Enhanced Recovery After Surgery (ERAS) protocol implementation and strengthening surveillance systems are critical to improving outcomes and reducing costs.

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来源期刊

Clinical Epidemiology and Global Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

4.60

自引率

7.70%

发文量

218

审稿时长

66 days

期刊介绍： Clinical Epidemiology and Global Health (CEGH) is a multidisciplinary journal and it is published four times (March, June, September, December) a year. The mandate of CEGH is to promote articles on clinical epidemiology with focus on developing countries in the context of global health. We also accept articles from other countries. It publishes original research work across all disciplines of medicine and allied sciences, related to clinical epidemiology and global health. The journal publishes Original articles, Review articles, Evidence Summaries, Letters to the Editor. All articles published in CEGH are peer-reviewed and published online for immediate access and citation.