Risk of surgical site infection after carpal tunnel release performed in an operating room versus a clinic-based procedure room within a Veterans Affairs medical center
| Autor: | V. Franklin Sechriest, Aaron S. DeVries, Amanda J. Halvorson, Amy Gravely |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Operating Rooms Outpatient Clinics Hospital Epidemiology Hospitals Veterans Logistic regression 03 medical and health sciences 0302 clinical medicine Single site Risk Factors Carpal tunnel release medicine Odds Ratio Humans Surgical Wound Infection 030212 general & internal medicine Veterans Affairs Aged 0303 health sciences 030306 microbiology business.industry Health Policy Public Health Environmental and Occupational Health Odds ratio Middle Aged Carpal Tunnel Syndrome Confidence interval United States United States Department of Veterans Affairs Infectious Diseases Ambulatory Surgical Procedures Emergency medicine Current Procedural Terminology Female business Surgical site infection |
| Zdroj: | American journal of infection control. 48(2) |
| ISSN: | 1527-3296 |
| Popis: | Background Carpal tunnel release (CTR) is increasingly performed in a clinic-based procedure room (PR) environment, which is less restrictive than traditional operating rooms (ORs). It is unknown if there is an impact on surgical site infection (SSI) rates. Methods Records of patients who underwent clean, elective CTR from October 2014 to April 2017 at a single site were identified using Current Procedural Terminology codes and charts reviewed using National Healthcare Safety Network SSI criteria. Procedure type and patient characteristics were assessed with multivariate logistic regression and costs compared using administrative data. Results A total of 312 procedures were included: 221 in OR and 91 in PR. SSI rate, including revisions, was 2.88% (nonrevision rate was 2.30%). Unadjusted SSI rate was 3.2% in OR and 2.2% in PR (P = .64). After adjusting for underlying risk factors, procedure setting was not associated with risk of SSI (P = .53; odds ratio, 0.43; 95% confidence interval, 0.03-5.94). Revision CTR was a predictor of SSI (P = .02; odds ratio, 28.21; 95% confidence interval, 1.84-434.57). The mean total cost of CTR in the OR was $4,254.21 and PR was $416.93. Conclusions There was no significant difference in SSI rates for CTR performed in OR and PR environments. CTRs performed in a PR led to a 10-fold cost savings. Based on our findings of PRs as both safe and cost-effective, we recommend that more facilities explore the use of PRs for CTR. |
| Databáze: | OpenAIRE |
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