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Almogbel GT, Altokhais TI, Alhothali A, Aljasser AS, Al-Qahtani KM, Arab SF, Alsweirki HMH, Albassam A. Risk Factors for Surgical Site Infections in Pediatric General Surgery: A Case–Control Study. J PEDIAT INF DIS-GER 2021. [DOI: 10.1055/s-0041-1726469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Abstract
Objective Despite being the most common postoperative complication and having associated morbidity and mortality that increase health care costs, surgical site infection (SSI) has not received adequate attention and deserves further study. Previous reports in children were limited to SSI in certain populations. We conducted this retrospective case–control study to determine the incidence and possible risk factors for SSI following pediatric general surgical procedures.
Methods This was a retrospective case–control matched cohort study of all patients aged 0 to 14 years who underwent pediatric general surgical procedures between June 2015 and July 2018. The electronic medical records were searched for a diagnosis of SSI. Control subjects were randomly selected at a 4:1 ratio from patients who underwent identical procedures. Multiple risk factors were evaluated by bivariate analysis and multivariable conditional logistic regression.
Results A total of 1,520 patients underwent a general pediatric procedure during the study period, and of these, 47 (3.09%) developed SSIs. A bivariate analysis showed that patients with SSIs were younger, were admitted to the neonatal intensive care unit/pediatric intensive care unit (NICU/PICU) preoperatively, were more severely ill as measured by the ASA classification, underwent multiple procedures, had more surgical complications, and were transferred to the NICU/PICU postoperatively. A multivariate analysis identified four independent predictors of SSI: age, preoperative NICU/PICU admission, number of procedures, and ASA classification.
Conclusion Younger children with preoperative admission to the NICU/PICU, those who underwent multiple procedures and those who were severely ill as measured by their ASA classification were significantly more likely to develop SSIs.
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Affiliation(s)
- Gassan T. Almogbel
- King Saud University Medical City & College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Tariq I. Altokhais
- Division of Pediatric Surgery, Department of Surgery, King Saud University Medical City & College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdulaziz Alhothali
- King Saud University Medical City & College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdulaziz Sami Aljasser
- King Saud University Medical City & College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Khalid M. Al-Qahtani
- King Saud University Medical City & College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Sadiq F. Arab
- King Saud University Medical City & College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Helmi M. H. Alsweirki
- King Saud University Medical City & College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdulrahman Albassam
- Division of Pediatric Surgery, Department of Surgery, King Saud University Medical City & College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Seyi-Olajide JO, Ameh EA. Global Health and Surgical Infection: From Neglect to Emerging Frontier. Surg Infect (Larchmt) 2020; 21:516-522. [PMID: 32315570 DOI: 10.1089/sur.2020.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Background: In past decades, surgical site infections (SSIs) were neglected and not given much global attention in low- and middle-income countries (LMICs). The risk and incidence of SSIs in LMICs continue to increase. Methods: We reviewed the limited quality data on SSIs and complicated intra-abdominal infections in these settings that have hampered advocacy and infection prevention and control efforts. Results: This review identifies the rising profile of global surgery that has resulted in efforts to scale up access to surgical care as well as increase surgical volumes to address unmet needs. The fallout of these efforts would be increasing SSI rates and a rising volume of laparotomies for intra-abdominal infections. Conclusion: Surgical infections are an emerging frontier in global health and surgery. There is an urgent need for global advocacy and investments in their prevention and control.
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Affiliation(s)
- Justina O Seyi-Olajide
- Paediatric Surgery Unit, Department of Surgery, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Emmanuel A Ameh
- Division of Paediatric Surgery, Department of Surgery, National Hospital, Abuja, Nigeria
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3
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Surgical site infection in elective clean and clean-contaminated surgeries in developing countries. Int J Infect Dis 2019; 80:34-45. [PMID: 30639405 DOI: 10.1016/j.ijid.2018.12.013] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 12/05/2018] [Accepted: 12/16/2018] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Surgical site infection (SSI) is both the most frequently studied healthcare-associated infection and the most common healthcare-associated infection in the developing world. A systematic review and meta-analysis was conducted to evaluate the relative size of this burden and to estimate the prevalence of SSI in clean and clean-contaminated surgeries in a large sample of countries in the developing world. METHODS A systematic search of the MEDLINE/PubMed, Scopus, and LILACS databases was conducted to identify studies providing the prevalence of SSI in elective clean and clean-contaminated surgeries in 39 countries or regions around the world. Data of interest were limited to publications from January 2000 to December 2017. Studies with information on the number of cases of SSI and number of total elective clean and clean-contaminated surgeries during the same period were included in this evaluation. Studies lacking clear definition of the total number of exposed patients were excluded. RESULTS Based on the combined data from the 99 articles evaluated in this analysis, the overall prevalence of SSI in elective clean and clean-contaminated surgeries was estimated to be 6% (95% confidence interval (CI) 5-7%). This increased to 15% (95% CI 6-27%) when considering only those reports with post-discharge surveillance data. The overall prevalence of SSI in Africa/Middle East, Latin America, Asia, and China was 10% (95% CI 6-15%), 7% (95% CI 5-10%), 4% (95% CI 4-5%), and 4% (95% CI 2-6%), respectively. Significant variability in the data was confirmed by both the funnel plot and the Egger test (p=0.008). CONCLUSIONS Although the data are variable, it is clear that the incidence of SSI in the developing world is higher than that in the developed world.
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Surgical site infection following elective nonspinal paediatric orthopaedic surgery: a prospective review. J Pediatr Orthop B 2019; 28:89-93. [PMID: 30252792 DOI: 10.1097/bpb.0000000000000549] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The aim of this study was to determine the rate of surgical site infection (SSI) and the factors that predispose to it in children undergoing nonspinal orthopaedic surgery. Over a 6-month period, 326 children who underwent 334 nonspinal elective orthopaedic surgical procedures were prospectively reviewed for the development of surgical site infections. A total of 14 sites became infected, with an overall infection rate of 4.19%. All the infections were superficial, and the only causative organism detected was Staphylococcus aureus. Operating times longer than 1 h and surgical wounds greater than 10 cm in length were positively associated with SSIs. Although there were differences between male and females, type of admission, the use of prophylactic antibiotics, degree of wound contamination and the grades of surgeons, these differences were not statistically significant. The results of this prospective study provide valuable information that was not previously available to the practicing paediatric orthopaedic surgeon.
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White MC, Longstaff L, Lai PS. Effect of Pre-operative Anaemia on Post-operative Complications in Low-Resource Settings. World J Surg 2017; 41:644-649. [PMID: 27837236 DOI: 10.1007/s00268-016-3785-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND In high-resource settings, even mild anaemia is associated with an increased risk of post-operative complications. Whether this is true in low-resource settings is unclear. We aimed to evaluate the effect of anaemia on surgical outcomes in the Republic of Congo and Madagascar. METHOD It is a retrospective chart review of 2064 non-pregnant patients undergoing elective surgery with Mercy Ships. Logistic regression was used to determine the association between pre-operative anaemia and pre-defined surgical complications, adjusted for age, gender, surgical specialty, and country. RESULTS The average age of patients was 27.2 years; 56.7% were male. Sixty-two percent of patients were not anaemic, and 22.7, 13.9 and 1.4% met sex-related criteria for mild, moderate and severe anaemia, respectively. In adjusted analyses, the severe anaemia group had an 8.58 [3.65, 19.49] higher odds of experiencing any surgical complication (p < 0.001) compared to non-anaemic patients. Analysis of each complication showed a 33.13 [9.57, 110.39] higher odds of unexpected ICU admission (p < 0.001); a 7.29 [1.98, 21.45] higher odds of surgical site infection (p < 0.001); and 7.48 [1.79, 25.78] higher odds of requiring hospital readmission (p < 0.001). Evaluating other anaemia categories, only those with moderate anaemia had a higher risk of requiring ICU admission (odds ratio 2.75 [1.00, 7.04], p = 0.04) compared to those without anaemia. CONCLUSION Our results indicate that in low-income settings, severe anaemia is associated with an increased risk of post-operative complications including unexpected ICU admission, surgical site infection and hospital readmission, whereas mild anaemia was not associated with increased post-operative complications.
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Affiliation(s)
- Michelle C White
- M/V Africa Mercy, Mercy Ships, Port au Toamasina, Toamasina, Madagascar.
| | - Lydia Longstaff
- M/V Africa Mercy, Mercy Ships, Port au Toamasina, Toamasina, Madagascar
| | - Peggy S Lai
- Massachusetts General Hospital, Boston, MA, 02114, USA
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Ngaroua, Ngah JE, Bénet T, Djibrilla Y. [Incidence of surgical site infections in sub-Saharan Africa: systematic review and meta-analysis]. Pan Afr Med J 2016; 24:171. [PMID: 27795768 PMCID: PMC5072885 DOI: 10.11604/pamj.2016.24.171.9754] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Accepted: 06/10/2016] [Indexed: 11/30/2022] Open
Abstract
Introduction Les Infections du Sites Opératoire (ISO) sont à l’origine de morbi-mortalité et des dépenses supplémentaires en santé. Les pays en développement en sont les plus touchés. L’objectif était d’estimer l’incidence poolée des ISO en Afrique Sub-saharienne et décrire ses principaux facteurs de risque. Méthodes Une revue systématique et une méta-analyse ont été effectuées à partir des bases de données de l’Organisation Mondiale de la Santé pour la Région Afrique, de PubMed et par recherche standard afin de sélectionner des articles électroniquespubliés entre 2006 et 2015. Seuls les articlestraitants de l’incidence et desfacteurs de risque des ISOdans les pays del’Afrique subsaharienneétaient retenus. Résultats Sur 95 articles trouvés, 11 ont répondu aux critères d’inclusion. Seulement 9 pays sur les 45 y ont contribués avec une grandereprésentation du Nigéria (5 articles sur 11). L’incidence des ISO variaient de 6,8% à 26% avec une prédominance en chirurgie générale. L’incidence poolée des ISO était de 14.8% (IC à 95%: 15,5-16,2%), avec une importante hétérogénéité selon la spécialité et le mode de surveillance. Les facteurs de risque les plus citésétaient la longue durée d’intervention et la classe de contamination d’Altemeir 3 et 4. Les autres facteurs concernaient l’environnement hospitalier, les pratiques de soins inadéquats et les pathologies sous-jacentes. Conclusion L’incidence des ISO est élevée en Afrique subsaharienne, des études dans cette région pourrait améliorer la connaissance, laprévention et la maitrise deces multiples facteurs de risques.
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Affiliation(s)
- Ngaroua
- Service de Chirurgie, Hôpital Régional de Ngaoundéré, Cameroun; Département des Sciences Biomédicales, Université de Ngaoundéré, Cameroun
| | - Joseph Eloundou Ngah
- Neurochirurgie, Faculté de Médecine et des Sciences Biomédicales, Université de Yaoundé I, Cameroun
| | - Thomas Bénet
- Service d'Hygiène, Epidémiologie et Prévention, Hôpital Edouard Herriot, Hospices Civils de Lyon, France; Laboratoire des Pathogènes Emergents, Fondation Mérieux, Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France
| | - Yaouba Djibrilla
- Département des Sciences Biomédicales, Université de Ngaoundéré, Cameroun
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Peña-Fernández M, Solar-Vilariño I, Rodríguez-Álvarez MX, Zapardiel I, Estévez F, Gayoso-Diz P. Assessment of morbidity in gynaecologic oncology laparoscopy and identification of possible risk factors. Ecancermedicalscience 2015; 9:606. [PMID: 26715943 PMCID: PMC4679209 DOI: 10.3332/ecancer.2015.606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Indexed: 11/15/2022] Open
Abstract
Background The aim of this study was to ascertain the incidence of and the risk factors associated with morbidity in laparoscopy performed on patients with cervical cancer and endometrial cancer. Methods This was an observational study of a cohort of 128 women, 89 with endometrial cancer and 39 with cervical cancer from January 2000 to December 2011. We used the Student’s t-test or the Mann-Whitney U test for continuous variables, and the Chi-square or Fisher’s exact test for categorical variables. Results Complications were found in 44 patients (34.4%). After a multivariate analysis, among the risk factors associated with the presence of complications as the only type of surgery was found to be statistically significant (p = 0.043), more frequent in the most complex procedures such as Wertheim operation, trachelectomy, and para-aortic lymphadenectomy. Type of surgery (p = 0.003) and tumour type (p = 0.003) were risk factors associated with conversion to laparotomy. It was more frequent among the most complex procedures and cervical cancer cases. Regarding the need for transfusion, significant differences were observed in terms of surgery duration (p < 0.001), more frequent in longer surgery. Conclusion Morbidity in laparoscopic surgical oncology is related to the surgery complexity, where the basal characteristics of the patient are not a factor of influence in the development of complications.
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Affiliation(s)
- Maite Peña-Fernández
- Department of Gynecology and Obstetrics, Santiago de Compostela University Clinical Teaching Hospital, Spain
| | - Inés Solar-Vilariño
- Department of Gynecology and Obstetrics, Santiago de Compostela University Clinical Teaching Hospital, Spain
| | - María Xosé Rodríguez-Álvarez
- Clinical Epidemiology and Biostatistics Unit, Santiago de Compostela University Clinical Teaching Hospital and Santiago Health Research Institute, Spain
| | - Ignacio Zapardiel
- Gynecologic Oncology Unit, La Paz University Hospital, Madrid, Spain
| | - Francisco Estévez
- Department of Gynecology and Obstetrics, POVISA Hospital, Vigo, Spain
| | - Pilar Gayoso-Diz
- Clinical Epidemiology and Biostatistics Unit, Santiago de Compostela University Clinical Teaching Hospital and Santiago Health Research Institute, Spain
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Daskalou E, Galli-Tsinopoulou A, Karagiozoglou-Lampoudi T, Augoustides-Savvopoulou P. Malnutrition in Hospitalized Pediatric Patients: Assessment, Prevalence, and Association to Adverse Outcomes. J Am Coll Nutr 2015; 35:372-80. [PMID: 26709552 DOI: 10.1080/07315724.2015.1056886] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Malnutrition is a frequent finding in pediatric health care settings in the form of undernutrition or excess body weight. Its increasing prevalence and impact on overall health status, which is reflected in the adverse outcomes, renders imperative the application of commonly accepted and evidence-based practices and tools by health care providers. Nutrition risk screening on admission and nutrition status evaluation are key points during clinical management of hospitalized pediatric patients, in order to prevent health deterioration that can lead to serious complications and growth consequences. In addition, anthropometric data based on commonly accepted universal growth standards can give accurate results for nutrition status. Both nutrition risk screening and nutrition status assessment are techniques that should be routinely implemented, based on commonly accepted growth standards and methodology, and linked to clinical outcomes. The aim of the present review was to address the issue of hospital malnutrition in pediatric settings in terms of prevalence, outline nutrition status evaluation and nutrition screening process using different criteria and available tools, and present its relationship with outcome measures. Key teaching points • Malnutrition-underweight or excess body weight-is a frequent imbalance in pediatric settings that affects physical growth and results in undesirable clinical outcomes. • Anthropometry interpretation through growth charts and nutrition screening are cornerstones for the assessment of malnutrition.To date no commonly accepted anthropometric criteria or nutrition screening tools are used in hospitalized pediatric patients. • Commonly accepted nutrition status and screening processes based on the World Health Organization's growth standards can contribute to the overall hospital nutrition care of pediatric patients.
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Affiliation(s)
- Efstratia Daskalou
- a Clinical Nutrition Laboratory "Christos Mantzoros", Nutrition & Dietetics Department, Alexander Technological Educational Institute of Thessaloniki , Thessaloniki , GREECE ;,b 4th Pediatric Department (A.G.-T.), 1st Pediatric Department (P.A.-S.) , Medical School, Aristotle University of Thessaloniki , Thessaloniki , GREECE
| | - Assimina Galli-Tsinopoulou
- a Clinical Nutrition Laboratory "Christos Mantzoros", Nutrition & Dietetics Department, Alexander Technological Educational Institute of Thessaloniki , Thessaloniki , GREECE ;,b 4th Pediatric Department (A.G.-T.), 1st Pediatric Department (P.A.-S.) , Medical School, Aristotle University of Thessaloniki , Thessaloniki , GREECE
| | - Thomais Karagiozoglou-Lampoudi
- a Clinical Nutrition Laboratory "Christos Mantzoros", Nutrition & Dietetics Department, Alexander Technological Educational Institute of Thessaloniki , Thessaloniki , GREECE ;,b 4th Pediatric Department (A.G.-T.), 1st Pediatric Department (P.A.-S.) , Medical School, Aristotle University of Thessaloniki , Thessaloniki , GREECE
| | - Persefone Augoustides-Savvopoulou
- a Clinical Nutrition Laboratory "Christos Mantzoros", Nutrition & Dietetics Department, Alexander Technological Educational Institute of Thessaloniki , Thessaloniki , GREECE ;,b 4th Pediatric Department (A.G.-T.), 1st Pediatric Department (P.A.-S.) , Medical School, Aristotle University of Thessaloniki , Thessaloniki , GREECE
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9
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Liu X, Duan X, Xu J, Jin Q, Chen F, Wang P, Yang Y, Tang X. Impact of intra-operative intraperitoneal chemotherapy on organ/space surgical site infection in patients with gastric cancer. J Hosp Infect 2015. [PMID: 26215613 DOI: 10.1016/j.jhin.2015.05.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Various risk factors for surgical site infection (SSI) have been identified such as age, overweight, duration of surgery, blood loss, etc. Intraperitoneal chemotherapy during surgery is a common procedure in patients with gastric cancer, yet its impact on SSI has not been evaluated. AIM To evaluate whether intra-operative intraperitoneal chemotherapy is a key risk factor for organ/space SSI in patients with gastric cancer. METHODS All patients with gastric cancer who underwent surgery at the Department of Gastrointestinal Surgery between January 2008 and December 2013 were studied. The organ/space SSI rates were compared between patients who received intra-operative intraperitoneal chemotherapy and patients who did not receive intra-operative intraperitoneal chemotherapy, and the risk factors for organ/space SSI were analysed by univariate and multi-variate regression analyses. The microbial causes of organ/space SSI were also identified. FINDINGS Of the eligible 845 patients, 356 received intra-operative intraperitoneal chemotherapy, and the organ/space SSI rate was higher in these patients compared with patients who did not receive intra-operative intraperitoneal chemotherapy (9.01% vs 3.88%; P = 0.002). Univariate analysis confirmed the significance of this finding (odds ratio 2.443; P = 0.003). As a result, hospital stay was increased in patients who received intra-operative intraperitoneal chemotherapy {mean 20.91 days [95% confidence interval (CI) 19.76-22.06] vs 29.72 days (95% CI 25.46-33.99); P = 0.000}. The results also suggested that intra-operative intraperitoneal chemotherapy may be associated with more Gram-negative bacterial infections. CONCLUSION Intra-operative intraperitoneal chemotherapy is a significant risk factor for organ/space SSI in patients with gastric cancer.
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Affiliation(s)
- X Liu
- Department of Hospital Infection Management, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China
| | - X Duan
- Department of Head and Neck Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China
| | - J Xu
- Department of Head and Neck Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China.
| | - Q Jin
- Department of Gastrointestinal Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China
| | - F Chen
- Department of Hospital Network Information Centre, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China
| | - P Wang
- Department of Hospital Infection Management, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China
| | - Y Yang
- Department of Gastrointestinal Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China
| | - X Tang
- Department of Public Health, Guangxi Medical University, Nanning, China
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Brahmbhatt R, Carter SA, Hicks SC, Berger DH, Liang MK. Identifying Risk Factors for Surgical Site Complications after Laparoscopic Ventral Hernia Repair: Evaluation of the Ventral Hernia Working Group Grading System. Surg Infect (Larchmt) 2014; 15:187-93. [DOI: 10.1089/sur.2012.179] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Reshma Brahmbhatt
- Michael E. DeBakey Department of Surgery, Michael E. DeBakey Veterans Affairs Medical Center, Baylor College of Medicine, Houston, Texas
| | - Stacey A. Carter
- Michael E. DeBakey Department of Surgery, Michael E. DeBakey Veterans Affairs Medical Center, Baylor College of Medicine, Houston, Texas
| | | | - David H. Berger
- Michael E. DeBakey Department of Surgery, Michael E. DeBakey Veterans Affairs Medical Center, Baylor College of Medicine, Houston, Texas
| | - Mike K. Liang
- Michael E. DeBakey Department of Surgery, Michael E. DeBakey Veterans Affairs Medical Center, Baylor College of Medicine, Houston, Texas
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Alp E, Kalin G, Coskun R, Sungur M, Guven M, Doganay M. Economic burden of ventilator-associated pneumonia in a developing country. J Hosp Infect 2012; 81:128-30. [PMID: 22552163 DOI: 10.1016/j.jhin.2012.03.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Accepted: 03/06/2012] [Indexed: 01/15/2023]
Abstract
Ventilator-associated pneumonia (VAP) developed in 96 (60%) of 159 patients with 37.2 cases per 1000 ventilation-days in a medical intensive care unit (MICU). Median time for VAP development was 5.5 days (range: 2-25). The most significant risk factors for VAP were stay in hospital before MICU and length of stay in MICU. The mean length of stay in MICU for VAP patients was 23.8 ± 19.8 days, which was four-fold higher than for non-VAP patients. The daily cost for VAP patients was half that for non-VAP patients. The total costs for VAP patients were about three-fold higher than for non-VAP patients.
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Affiliation(s)
- E Alp
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
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