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Associations Between Surgical Site Infection Risk and Hospital Operation Volume and Surgeon Operation Volume Among Hospitals in the Dutch Nosocomial Infection Surveillance Network

Published online by Cambridge University Press:  02 January 2015

Jan Muilwijk ,
Susan van den Hof  and
Jan C. Wille
Jan Muilwijk*
Affiliation:
National Institute of Public Health and the Environment, Centre for Infectious Disease Epidemiology, Bilthoven, The Netherlands
Susan van den Hof
Affiliation:
National Institute of Public Health and the Environment, Centre for Infectious Disease Epidemiology, Bilthoven, The Netherlands KNCV Tuberculosis Foundation, The Hague, The Netherlands
Jan C. Wille
Affiliation:
Dutch Institute for Healthcare Improvement, Utrecht, The Netherlands
*
National Institute of Public Health and the Environment (PB 75), PO Box 1, 3720 BA, Bilthoven, The Netherlands (Jan.Muilwijk@rivm.nl)
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Abstract

Objective.

To examine the association between hospital operation volume and surgeon operation volume and the risk of surgical site infection (SSI).

Design.

Prospective, multicenter cohort study based on surveillance data.

Methods.

Data were obtained from the Dutch surveillance network for nosocomial infections (Preventie Ziekenhuisinfecties door Surveillance [PREZIES]) on 9 different types of orthopedic surgery, general surgery, and gynecology procedures performed during 1996-2003. Multilevel logistic regression analysis was performed to assess the independent effect of hospital volume and surgeon volume on SSI risk.

Results.

Hospital volume was not significantly associated with SSI risk for any of the selected procedures. Low surgeon volume was associated with an increased risk for an infection for 7 of 9 types of procedures, although this effect was statistically significant only for knee arthroplasty. For 4 procedures, the odds of exceeding the 75th percentile for duration of surgery were greater when the surgeon volume was low than when the surgeon volume was moderate or high.

Conclusions.

Patients operated on by surgeons with a low operation volume seem to have a higher risk of developing an SSI with some procedures, particularly knee arthroplasty. The higher SSI risk for surgeons with a low operation volume is possibly partly mediated by the longer duration of surgery, a well-known risk factor for development of SSI.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 28 , Issue 5 , May 2007 , pp. 557 - 563
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2007

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