Readmission after delayed diagnosis of surgical site infection: a focus on prevention using the American College of Surgeons National Surgical Quality Improvement Program.

Academic Article

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.

    • Authors

    Keywords

  • National Surgical Quality Improvement Program, Readmission, Surgical site infection, Delayed Diagnosis, Female, Humans, Male, Middle Aged, Patient Readmission, Population Surveillance, Quality Improvement, Retrospective Studies, Risk Factors, Surgical Wound Infection, Wisconsin

    • Digital Object Identifier (doi)

    Author List

  • Gibson A; Tevis S; Kennedy G

    • Start Page

  • 832

    • End Page

  • 839

    • Volume

  • 207

    • Issue

  • 6