Surgical-site infections after orthopaedic surgery : statewide surveillance using linked administrative databases

Carla Thomas, H.L. Cadwallader, Thomas Riley

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Prospective surveillance programmes to monitor the incidence of surgical-site infection (SSI) in patients who have had orthopaedic implant surgery can be difficult to implement due to limited human and technical resources. In addition, prolonged patient follow-up, up to one year, may be required. Traditional methods of surveillance can be enhanced by using administrative databases to assist in case finding and facilitate overall surveillance activities. The aim of this study was to identify the incidence of SSI in patients who had undergone total hip replacement (THR) or total knee replacement (TKR) surgery in all Western Australian (WA) hospitals during 1999 using the Western Australian Data Linkage System. The WA Data Linkage System links several population-based administrative health datasets within the state, including the Hospital Morbidity Data System (HMDS), containing International Classification of Disease-coded discharge information, and mortality records. A total of 1476 THR and 1875 TKR procedures was identified from 21 WA hospitals during 1999. The incidence of SSI after these procedures was 5% (95% CI 4.3–5.7) [THR (4.86%, 95% CI 3.77–5.95) and TKR (5.15%, 95% CI 4.15–6.15)]. The incidence was 33.72 infections per 1000 person-years. Patients aged over 80 years experienced a significantly higher rate of infection after THR compared with patients aged 80 or less (z-test, z=2.56, P=0.015), but not for TKR. No patients with an SSI died during follow-up. The WA Data Linkage System provided a unique opportunity to review the incidence of SSIs in patients undergoing THR or TKR surgery in WA hospitals.
Original languageEnglish
Pages (from-to)25-30
JournalJournal of Hospital Infection
Volume57
Issue number1
DOIs
Publication statusPublished - 2004

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Surgical Wound Infection
Orthopedics
Knee Replacement Arthroplasties
Hip Replacement Arthroplasties
Databases
Information Systems
Information Storage and Retrieval
Incidence
State Hospitals
International Classification of Diseases
Infection
Morbidity
Mortality
Health
Population

Cite this

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title = "Surgical-site infections after orthopaedic surgery : statewide surveillance using linked administrative databases",
abstract = "Prospective surveillance programmes to monitor the incidence of surgical-site infection (SSI) in patients who have had orthopaedic implant surgery can be difficult to implement due to limited human and technical resources. In addition, prolonged patient follow-up, up to one year, may be required. Traditional methods of surveillance can be enhanced by using administrative databases to assist in case finding and facilitate overall surveillance activities. The aim of this study was to identify the incidence of SSI in patients who had undergone total hip replacement (THR) or total knee replacement (TKR) surgery in all Western Australian (WA) hospitals during 1999 using the Western Australian Data Linkage System. The WA Data Linkage System links several population-based administrative health datasets within the state, including the Hospital Morbidity Data System (HMDS), containing International Classification of Disease-coded discharge information, and mortality records. A total of 1476 THR and 1875 TKR procedures was identified from 21 WA hospitals during 1999. The incidence of SSI after these procedures was 5{\%} (95{\%} CI 4.3–5.7) [THR (4.86{\%}, 95{\%} CI 3.77–5.95) and TKR (5.15{\%}, 95{\%} CI 4.15–6.15)]. The incidence was 33.72 infections per 1000 person-years. Patients aged over 80 years experienced a significantly higher rate of infection after THR compared with patients aged 80 or less (z-test, z=2.56, P=0.015), but not for TKR. No patients with an SSI died during follow-up. The WA Data Linkage System provided a unique opportunity to review the incidence of SSIs in patients undergoing THR or TKR surgery in WA hospitals.",
author = "Carla Thomas and H.L. Cadwallader and Thomas Riley",
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