Abstract
Background
Surgical site infection (SSI) is a costly complication leading to increased resource
use and patient morbidity. We hypothesized that postdischarge SSI results in a high
rate of preventable readmissions.
Methods
We used our institutional American College of Surgeons National Surgical Quality Improvement
Program database to identify patients undergoing general surgery procedures from 2006
to 2011.
Results
SSIs developed in 10% of the 3,663 patients who underwent an inpatient general surgical
procedure. SSI was diagnosed after discharge in 48% of patients. Patients with a diagnosis
of SSI after discharge were less likely to have a history of smoking (15% vs 28%,
P = .001), chronic obstructive pulmonary disease (3% vs 9%, P = .015), congestive heart failure (0% vs 3%, P = .03), or sepsis within 48 hours preoperatively (17% vs 32%, P = .001) compared with patients diagnosed before discharge. Over 50% of the patients
diagnosed with SSI after discharge required readmission.
Conclusions
A diagnosis of SSI after discharge is associated with a high readmission rate despite
occurring in healthier patients. We propose discharge teaching improvements and a
wound surveillance clinic within the first week may result in a decreased readmission
rate.
Keywords
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Article info
Publication history
Published online: October 14, 2013
Received in revised form:
May 24,
2013
Received:
April 5,
2013
Footnotes
The authors declare no conflict of interest.
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
