The costs of surgical site infection after abdominal surgery in middle-income countries: Key resource use In Wound Infection (KIWI) study.

Autor: Monahan M; Health Economics Unit, Institute of Applied Health, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK. Electronic address: m.monahan.1@bham.ac.uk., Glasbey J; NIHR Global Health and Global Surgery Unit, Institute of Translational Medicine, Heritage Building, University of Birmingham, Birmingham, UK., Roberts TE; Health Economics Unit, Institute of Applied Health, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK; NIHR Global Health and Global Surgery Unit, Institute of Translational Medicine, Heritage Building, University of Birmingham, Birmingham, UK., Jowett S; NIHR Global Health and Global Surgery Unit, Institute of Translational Medicine, Heritage Building, University of Birmingham, Birmingham, UK., Pinkney T; Birmingham Surgical Trials Consortium, Institute of Applied Health, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK., Bhangu A; NIHR Global Health and Global Surgery Unit, Institute of Translational Medicine, Heritage Building, University of Birmingham, Birmingham, UK., Morton DG; NIHR Global Health and Global Surgery Unit, Institute of Translational Medicine, Heritage Building, University of Birmingham, Birmingham, UK; Birmingham Surgical Trials Consortium, Institute of Applied Health, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK., de la Medina AR; Global Surgery Research Centre, Hospital Español de Veracruz, Veracruz, Mexico., Ghosh D; India Hub NIHR Global Health Research Unit on Global Surgery, Ludhiana, India; Department of Anaesthesia and Surgery, Christian Medical College, Ludhiana, India., Ademuyiwa AO; Department of Surgery, College of Medicine and Lagos University Teaching Hospital, Lagos, Nigeria., Ntirenganya F; Department of Surgery, University of Rwanda, Kigali, Rwanda., Tabiri S; Department of Surgery, School of Medicine and Health Sciences, University for Development Studies and Tamale Teaching Hospital, Tamale, Ghana.
Jazyk: angličtina
Zdroj: The Journal of hospital infection [J Hosp Infect] 2023 Jun; Vol. 136, pp. 38-44. Date of Electronic Publication: 2023 Apr 21.
DOI: 10.1016/j.jhin.2023.03.023
Abstrakt: Background: Surgical site infection (SSI) is the most common complication of abdominal surgery, with substantial costs to patients and health systems. Heterogeneity in costing methods in existing SSI studies makes multi-country comparison challenging. The objective of the study was to assess the costs of SSI across middle-income countries.
Methods: Centres from a randomized controlled trial assessing interventions to reduce SSI (FALCON, ClinicalTrials.gov, NCT03700749NCT) were sampled from two upper-middle- (India, Mexico) and two lower-middle- (Ghana, Nigeria) income countries. The Key resource use In Wound Infection (KIWI) study collected data on postoperative resource use and costs from consecutive patients undergoing abdominal surgery with an incision >5 cm (including caesarean section) that were recruited to FALCON between April and October 2020. The overall costs faced by patients with and without SSI were compared by operative field contamination (clean-contaminated vs contaminated-dirty), country and timing (inpatient vs outpatient).
Findings: A total of 335 patients were included in KIWI; SSI occurred in 7% of clean-contaminated cases and 27% of contaminated-dirty cases. Overall, SSI was associated with an increase in postoperative healthcare costs by 75.3% (€412 international Euros) after clean-contaminated surgery and 66.6% (€331) after contaminated-dirty surgery. The highest and lowest cost increases were in India for clean-contaminated cases (€517) and contaminated-dirty cases (€223), respectively. Overall, inpatient costs accounted for 96.4% of the total healthcare costs after clean-contaminated surgery and 92.5% after contaminated-dirty surgery.
Conclusion: SSI was associated with substantial additional postoperative costs across a range of settings. Investment in health technologies to reduce SSI may mitigate the financial burden to patients and low-resource health systems.
(Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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