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Surgical Site Infection Affects Length of Stay After Complex Head and Neck Procedures
Objectives/Hypothesis Quality improvement (QI) initiatives emphasize a need for reduction in hospital length of stay (LOS). We sought to determine the impact of surgical site infections (SSIs) on LOS after complex head and neck surgery (HNS). Study Design Retrospective cohort analysis. Methods An an...
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| Published in: | The Laryngoscope 2020-12, Vol.130 (12), p.E837-E842 |
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| Main Authors: | , , , , , , |
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| cites | cdi_FETCH-LOGICAL-c3572-b21fd5c97a436bb89bc38a86e0637d9e66ccd12e9caf1f21f95d2aad8c9d78e33 |
| container_end_page | E842 |
| container_issue | 12 |
| container_start_page | E837 |
| container_title | The Laryngoscope |
| container_volume | 130 |
| creator | Lebo, Nicole L. Quimby, Alexandra E. Caulley, Lisa Thavorn, Kednapa Kekre, Natasha Brode, Sarah Johnson‐Obaseki, Stephanie |
| description | Objectives/Hypothesis
Quality improvement (QI) initiatives emphasize a need for reduction in hospital length of stay (LOS). We sought to determine the impact of surgical site infections (SSIs) on LOS after complex head and neck surgery (HNS).
Study Design
Retrospective cohort analysis.
Methods
An analysis of the American College of Surgeons National Surgical Quality Improvement Program was undertaken. All adult patients undergoing complex HNS from 2005 to 2016 were included in the analysis. Our main outcomes were SSI incidence and increase in hospital LOS attributable to SSI.
Results
Of 4,014 patients identified, 16.5% developed SSI. History of smoking, diabetes, preoperative wound infection, contaminated or dirty wound classes, and prolonged operative time were found to significantly predict postoperative SSI. Adjusting for significant pre‐ and postoperative factors, SSI was associated with significantly increased LOS (hazard ratio = 0.486, 95% confidence interval: 0.419‐0.522).
Conclusions
SSI following complex HNS is associated with significantly increased hospital LOS. This result supports the need for institutional QI strategies that target SSIs after head and neck procedures in an effort to provide the highest quality care at the lowest possible cost. Our analysis identifies risk factors that can allow identification of patients at high risk of SSI and prolonged hospitalization.
Level of Evidence
2b Laryngoscope, 2020 |
| doi_str_mv | 10.1002/lary.28512 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2344266266</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2460970890</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3572-b21fd5c97a436bb89bc38a86e0637d9e66ccd12e9caf1f21f95d2aad8c9d78e33</originalsourceid><addsrcrecordid>eNp9kE1Lw0AQhhdRbP24-ANkwYsIqfuRZLPHUtQKRcUq6GnZ7E5qaprU3QTtv3dr1YMHYWCGmYeX4UHoiJIBJYSdV9qtBixLKNtCfZpwGsVSJtuoH448yhL21EN73s8JoYInZBf1OJVCEEH76HHauVlpdIWnZQv4ui7AtGVT42GxnjyeQD1rX3BT4GmrV2HdgsOjZrGs4AOPQVusa4tvwLziO9cYsJ0Df4B2Cl15OPzu--jx8uJhNI4mt1fXo-EkMjwRLMoZLWxipNAxT_M8k7nhmc5SICkXVkKaGmMpA2l0QYsAy8QyrW1mpBUZcL6PTje5S9e8deBbtSi9garSNTSdV4zHMUvTUAE9-YPOm87V4TvF4pRIQTJJAnW2oYxrvHdQqKUrF8GvokStZau1bPUlO8DH35FdvgD7i_7YDQDdAO9lBat_otRkeP-8Cf0EjUeJEg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2460970890</pqid></control><display><type>article</type><title>Surgical Site Infection Affects Length of Stay After Complex Head and Neck Procedures</title><source>Wiley</source><creator>Lebo, Nicole L. ; Quimby, Alexandra E. ; Caulley, Lisa ; Thavorn, Kednapa ; Kekre, Natasha ; Brode, Sarah ; Johnson‐Obaseki, Stephanie</creator><creatorcontrib>Lebo, Nicole L. ; Quimby, Alexandra E. ; Caulley, Lisa ; Thavorn, Kednapa ; Kekre, Natasha ; Brode, Sarah ; Johnson‐Obaseki, Stephanie</creatorcontrib><description>Objectives/Hypothesis
Quality improvement (QI) initiatives emphasize a need for reduction in hospital length of stay (LOS). We sought to determine the impact of surgical site infections (SSIs) on LOS after complex head and neck surgery (HNS).
Study Design
Retrospective cohort analysis.
Methods
An analysis of the American College of Surgeons National Surgical Quality Improvement Program was undertaken. All adult patients undergoing complex HNS from 2005 to 2016 were included in the analysis. Our main outcomes were SSI incidence and increase in hospital LOS attributable to SSI.
Results
Of 4,014 patients identified, 16.5% developed SSI. History of smoking, diabetes, preoperative wound infection, contaminated or dirty wound classes, and prolonged operative time were found to significantly predict postoperative SSI. Adjusting for significant pre‐ and postoperative factors, SSI was associated with significantly increased LOS (hazard ratio = 0.486, 95% confidence interval: 0.419‐0.522).
Conclusions
SSI following complex HNS is associated with significantly increased hospital LOS. This result supports the need for institutional QI strategies that target SSIs after head and neck procedures in an effort to provide the highest quality care at the lowest possible cost. Our analysis identifies risk factors that can allow identification of patients at high risk of SSI and prolonged hospitalization.
Level of Evidence
2b Laryngoscope, 2020</description><identifier>ISSN: 0023-852X</identifier><identifier>ISSN: 1531-4995</identifier><identifier>EISSN: 1531-4995</identifier><identifier>DOI: 10.1002/lary.28512</identifier><identifier>PMID: 31977071</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>Aged ; Cohort Studies ; Female ; Head - surgery ; head and neck surgery ; Humans ; Infections ; length of stay ; Length of Stay - statistics & numerical data ; Male ; Maxillofacial surgery ; Middle Aged ; Neck - surgery ; Quality control ; quality improvement ; Retrospective Studies ; Surgical outcomes ; Surgical site infection ; Surgical site infections ; Surgical Wound Infection - epidemiology</subject><ispartof>The Laryngoscope, 2020-12, Vol.130 (12), p.E837-E842</ispartof><rights>2020 The American Laryngological, Rhinological and Otological Society, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3572-b21fd5c97a436bb89bc38a86e0637d9e66ccd12e9caf1f21f95d2aad8c9d78e33</citedby><cites>FETCH-LOGICAL-c3572-b21fd5c97a436bb89bc38a86e0637d9e66ccd12e9caf1f21f95d2aad8c9d78e33</cites><orcidid>0000-0002-4262-0342 ; 0000-0003-4864-8917 ; 0000-0003-4738-8447</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31977071$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lebo, Nicole L.</creatorcontrib><creatorcontrib>Quimby, Alexandra E.</creatorcontrib><creatorcontrib>Caulley, Lisa</creatorcontrib><creatorcontrib>Thavorn, Kednapa</creatorcontrib><creatorcontrib>Kekre, Natasha</creatorcontrib><creatorcontrib>Brode, Sarah</creatorcontrib><creatorcontrib>Johnson‐Obaseki, Stephanie</creatorcontrib><title>Surgical Site Infection Affects Length of Stay After Complex Head and Neck Procedures</title><title>The Laryngoscope</title><addtitle>Laryngoscope</addtitle><description>Objectives/Hypothesis
Quality improvement (QI) initiatives emphasize a need for reduction in hospital length of stay (LOS). We sought to determine the impact of surgical site infections (SSIs) on LOS after complex head and neck surgery (HNS).
Study Design
Retrospective cohort analysis.
Methods
An analysis of the American College of Surgeons National Surgical Quality Improvement Program was undertaken. All adult patients undergoing complex HNS from 2005 to 2016 were included in the analysis. Our main outcomes were SSI incidence and increase in hospital LOS attributable to SSI.
Results
Of 4,014 patients identified, 16.5% developed SSI. History of smoking, diabetes, preoperative wound infection, contaminated or dirty wound classes, and prolonged operative time were found to significantly predict postoperative SSI. Adjusting for significant pre‐ and postoperative factors, SSI was associated with significantly increased LOS (hazard ratio = 0.486, 95% confidence interval: 0.419‐0.522).
Conclusions
SSI following complex HNS is associated with significantly increased hospital LOS. This result supports the need for institutional QI strategies that target SSIs after head and neck procedures in an effort to provide the highest quality care at the lowest possible cost. Our analysis identifies risk factors that can allow identification of patients at high risk of SSI and prolonged hospitalization.
Level of Evidence
2b Laryngoscope, 2020</description><subject>Aged</subject><subject>Cohort Studies</subject><subject>Female</subject><subject>Head - surgery</subject><subject>head and neck surgery</subject><subject>Humans</subject><subject>Infections</subject><subject>length of stay</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Male</subject><subject>Maxillofacial surgery</subject><subject>Middle Aged</subject><subject>Neck - surgery</subject><subject>Quality control</subject><subject>quality improvement</subject><subject>Retrospective Studies</subject><subject>Surgical outcomes</subject><subject>Surgical site infection</subject><subject>Surgical site infections</subject><subject>Surgical Wound Infection - epidemiology</subject><issn>0023-852X</issn><issn>1531-4995</issn><issn>1531-4995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9kE1Lw0AQhhdRbP24-ANkwYsIqfuRZLPHUtQKRcUq6GnZ7E5qaprU3QTtv3dr1YMHYWCGmYeX4UHoiJIBJYSdV9qtBixLKNtCfZpwGsVSJtuoH448yhL21EN73s8JoYInZBf1OJVCEEH76HHauVlpdIWnZQv4ui7AtGVT42GxnjyeQD1rX3BT4GmrV2HdgsOjZrGs4AOPQVusa4tvwLziO9cYsJ0Df4B2Cl15OPzu--jx8uJhNI4mt1fXo-EkMjwRLMoZLWxipNAxT_M8k7nhmc5SICkXVkKaGmMpA2l0QYsAy8QyrW1mpBUZcL6PTje5S9e8deBbtSi9garSNTSdV4zHMUvTUAE9-YPOm87V4TvF4pRIQTJJAnW2oYxrvHdQqKUrF8GvokStZau1bPUlO8DH35FdvgD7i_7YDQDdAO9lBat_otRkeP-8Cf0EjUeJEg</recordid><startdate>202012</startdate><enddate>202012</enddate><creator>Lebo, Nicole L.</creator><creator>Quimby, Alexandra E.</creator><creator>Caulley, Lisa</creator><creator>Thavorn, Kednapa</creator><creator>Kekre, Natasha</creator><creator>Brode, Sarah</creator><creator>Johnson‐Obaseki, Stephanie</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-4262-0342</orcidid><orcidid>https://orcid.org/0000-0003-4864-8917</orcidid><orcidid>https://orcid.org/0000-0003-4738-8447</orcidid></search><sort><creationdate>202012</creationdate><title>Surgical Site Infection Affects Length of Stay After Complex Head and Neck Procedures</title><author>Lebo, Nicole L. ; Quimby, Alexandra E. ; Caulley, Lisa ; Thavorn, Kednapa ; Kekre, Natasha ; Brode, Sarah ; Johnson‐Obaseki, Stephanie</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3572-b21fd5c97a436bb89bc38a86e0637d9e66ccd12e9caf1f21f95d2aad8c9d78e33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aged</topic><topic>Cohort Studies</topic><topic>Female</topic><topic>Head - surgery</topic><topic>head and neck surgery</topic><topic>Humans</topic><topic>Infections</topic><topic>length of stay</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Male</topic><topic>Maxillofacial surgery</topic><topic>Middle Aged</topic><topic>Neck - surgery</topic><topic>Quality control</topic><topic>quality improvement</topic><topic>Retrospective Studies</topic><topic>Surgical outcomes</topic><topic>Surgical site infection</topic><topic>Surgical site infections</topic><topic>Surgical Wound Infection - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lebo, Nicole L.</creatorcontrib><creatorcontrib>Quimby, Alexandra E.</creatorcontrib><creatorcontrib>Caulley, Lisa</creatorcontrib><creatorcontrib>Thavorn, Kednapa</creatorcontrib><creatorcontrib>Kekre, Natasha</creatorcontrib><creatorcontrib>Brode, Sarah</creatorcontrib><creatorcontrib>Johnson‐Obaseki, Stephanie</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>The Laryngoscope</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lebo, Nicole L.</au><au>Quimby, Alexandra E.</au><au>Caulley, Lisa</au><au>Thavorn, Kednapa</au><au>Kekre, Natasha</au><au>Brode, Sarah</au><au>Johnson‐Obaseki, Stephanie</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Surgical Site Infection Affects Length of Stay After Complex Head and Neck Procedures</atitle><jtitle>The Laryngoscope</jtitle><addtitle>Laryngoscope</addtitle><date>2020-12</date><risdate>2020</risdate><volume>130</volume><issue>12</issue><spage>E837</spage><epage>E842</epage><pages>E837-E842</pages><issn>0023-852X</issn><issn>1531-4995</issn><eissn>1531-4995</eissn><abstract>Objectives/Hypothesis
Quality improvement (QI) initiatives emphasize a need for reduction in hospital length of stay (LOS). We sought to determine the impact of surgical site infections (SSIs) on LOS after complex head and neck surgery (HNS).
Study Design
Retrospective cohort analysis.
Methods
An analysis of the American College of Surgeons National Surgical Quality Improvement Program was undertaken. All adult patients undergoing complex HNS from 2005 to 2016 were included in the analysis. Our main outcomes were SSI incidence and increase in hospital LOS attributable to SSI.
Results
Of 4,014 patients identified, 16.5% developed SSI. History of smoking, diabetes, preoperative wound infection, contaminated or dirty wound classes, and prolonged operative time were found to significantly predict postoperative SSI. Adjusting for significant pre‐ and postoperative factors, SSI was associated with significantly increased LOS (hazard ratio = 0.486, 95% confidence interval: 0.419‐0.522).
Conclusions
SSI following complex HNS is associated with significantly increased hospital LOS. This result supports the need for institutional QI strategies that target SSIs after head and neck procedures in an effort to provide the highest quality care at the lowest possible cost. Our analysis identifies risk factors that can allow identification of patients at high risk of SSI and prolonged hospitalization.
Level of Evidence
2b Laryngoscope, 2020</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>31977071</pmid><doi>10.1002/lary.28512</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-4262-0342</orcidid><orcidid>https://orcid.org/0000-0003-4864-8917</orcidid><orcidid>https://orcid.org/0000-0003-4738-8447</orcidid></addata></record> |
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| ispartof | The Laryngoscope, 2020-12, Vol.130 (12), p.E837-E842 |
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| source | Wiley |
| subjects | Aged Cohort Studies Female Head - surgery head and neck surgery Humans Infections length of stay Length of Stay - statistics & numerical data Male Maxillofacial surgery Middle Aged Neck - surgery Quality control quality improvement Retrospective Studies Surgical outcomes Surgical site infection Surgical site infections Surgical Wound Infection - epidemiology |
| title | Surgical Site Infection Affects Length of Stay After Complex Head and Neck Procedures |
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