Ten years of surveillance of Surgical Site Infections (SSIS) in Piedmont: trends and burden for hip prosthesis and colon surgery
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Department of Public Health and Pediatric Sciences, University of Turin, Italy
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A1921
Surveillance programs have proven effective in reducing rates of surgical site infections (SSIs). The aim of this study was to evaluate rates and trends of SSIs following hip arthroplasty (HPRO) and colon surgery procedures (COLO) in Piedmont, a region in North-western Italy, from 2010 to 2019. Further, we aimed to assess the burden of SSIs in terms of Disability-Adjusted Life-Years (DALYs). A prospective cohort study was conducted among 42 hospitals participating in the surveillance system. Procedure-specific SSI rates were calculated and 10-year trend was assessed using chi-squared test for trends, using Epi InfoTM. Patients were stratified according to age, sex and IRI index according to life expectancy in order to calculate DALYs, using a modified version of the ECDC’s BCoDE toolkit: disease models for both surgeries were altered to incorporate long-term disability associated with SSIs. 20356 HPRO and 11011 COLO procedures were monitored over 10 years, all of which were included in the analyses. HPRO and COLO cumulative SSIs rates were 1.5% and 8% respectively. Chi-squared test showed a significant trend: 2019 patients undergoing HPRO surgery is 17.7% less likely to contract SSIs than 2010 patients (OR: 0.823; p<0.001), whilst 2019 patients undergoing COLO surgery is 35.7% less likely to contract SSIs than 2010 patients (OR: 0.643; p<0.001). Regarding disease burden, a total of 955.3 (95%CI 837.7-1102.98) and 208.65 (95%CI 180.87-240.90) DALYs were calculated for SSIs following HPRO, whilst 76.58 (95%CI 67.15-90.71) and 38.62 (95% CI 33.09-45.36) DALYs for SSIs in COLO, in 2010 and 2019, respectively. The significant decreasing trends found in this study support of the effectiveness of surveillance networks in reducing SSI rates and improving quality of care. Despite the smaller SSI rate, the burden associated with SSIs following HPRO was higher, which is important to consider in light of the ageing population in Italy.