Validation of a semi-automated surveillance system for surgical site infections: Improving exhaustiveness, representativeness, and efficiency

• Type: Article in International Scientific Journal
• Date: 2020

Authors

Malheiro, R (Author) Other; Rocha Pereira, N (Author) FMUP; Duro, R (Author) Other; Pereira, C (Author) Other; Alves, CL (Author) Other; Correia, S (Author) FMUP

Journal

The Journal is awaiting validation by the Administrative Services.

Title: INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES

Vol. 99

Pages: 355-361

ISSN: 1201-9712

Indexing

ISI Web of Knowledge - 0 Citations

Scopus - 0 Citations

Other information

Authenticus ID: P-00S-PEZ

DOI: 10.1016/j.ijid.2020.07.035

Abstract (EN): Objectives: To assess whether electronic records data could improve the efficiency, exhaustiveness, and representativeness of SSI surveillance by selecting a group of high-risk patients for manual review. Methods: Colorectal surgeries (2016-2018) and cholecystectomies (2017-2018) were selected. Post-surgical antibiotic use, positive culture, C-reactive protein (CRP) values, body temperature, leukocyte count, surgical re-intervention, admission to the emergency room, and hospital readmission were retrieved. For representativeness, procedures registered in HAI-Net were compared with non-included procedures, and the validity of each variable (or combination) was tested considering the presence of SSI as the gold standard. The proportion of procedures flagged for manual review by each criterion was estimated. Results: Little more than 50% of procedures were included in HAI-Net (SSI risk: 10.6% for colorectal and 2.9% for cholecystectomies). Non-included procedures showed higher proportions of infection markers. Antibiotic use and CRP >100 mg/dl presented the highest sensitivity for both surgical groups, while antibiotic use achieved the highest positive predictive value in both groups (22% and 21%, respectively) and flagged fewer colorectal procedures (47.7%). Conclusions: Current SSI surveillance has major limitations. Thus, the reported incidence seems unreliable and underestimated. Antibiotic use appears to be the best criterion to select a sub-sample of procedures for manual review, improving the exhaustiveness and efficiency of the system. (C) 2020 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 7