Hip prosthesis and colon surgery, a decade of surveillance on surgical site infections in Italy, a prospective cohort study: rates, trends, and disease burden in DALYs

Valerio Bordino; Costanza Vicentini; Alessandro Roberto Cornio; Maria Michela Gianino; Carla Maria Zotti

doi:10.1186/s13756-024-01377-6

Hip prosthesis and colon surgery, a decade of surveillance on surgical site infections in Italy, a prospective cohort study: rates, trends, and disease burden in DALYs

Antimicrob Resist Infect Control. 2024 Feb 12;13(1):17. doi: 10.1186/s13756-024-01377-6.

Authors

Valerio Bordino¹, Costanza Vicentini², Alessandro Roberto Cornio², Maria Michela Gianino², Carla Maria Zotti²

Affiliations

¹ Paediatrics and Public Health Sciences Department, University of Turin, Via Santena 5bis, 10126, Turin, Italy. valerio.bordino@unito.it.
² Paediatrics and Public Health Sciences Department, University of Turin, Via Santena 5bis, 10126, Turin, Italy.

Abstract

Background: Surveillance programs are a key element of interventions aiming to reduce rates of surgical site infections (SSIs). The aim of this study was to evaluate rates and trends of SSIs following hip arthroplasty and colon surgery procedures in Piedmont, a region in North-western Italy, from 2010 to 2019. Further, we aimed to assess the burden of SSIs in terms of Disability-Adjusted Life-Years (DALYs).

Methods: A prospective cohort study was conducted among 42 hospitals participating in the surveillance system. Procedure-specific SSI rates were calculated and the 2010 - 2019 trend was evaluated using Spearman's Rho test. Patients were stratified according to age, sex and infection risk index according to life expectancy in order to calculate DALYs, using a modified version of the ECDC's BCoDE toolkit: disease models for both procedure types were adapted to incorporate long-term disability associated with SSIs.

Results: Overall, 20,356 hip arthroplasty and 11,011 colon surgery procedures were monitored over 10 years and were included in our analyses. Hip arthroplasty and colon surgery cumulative SSIs rates were 1.5% and 8% respectively. Using the Spearman's Rho test, we evaluated a significant downward trend from 2010 to 2019 for colon surgery interventions (Rs - 0.7, p < 0.05), while there was no difference for hip arthroplasty. (Rs - 0.04, p > 0.05). Regarding disease burden, a total of 955.3 (95%CI 837.7-1102.98) and 208.65 (95%CI 180.87-240.90) DALYs were calculated for SSIs following hip arthroplasty, whilst 76.58 (95%CI 67.15-90.71) and 38.62 (95% CI 33.09-45.36) DALYs for SSIs in colon surgery, in 2010 and 2019, respectively.

Conclusions: The significant decrease both in terms of incidence and DALYs found in this study for colon surgery and the stability for hip arthroplasty support the role of surveillance networks in improving quality of care. Despite the smaller SSI rate, the burden associated with SSIs following hip arthroplasty was higher, which is important to consider in light of the aging population in Italy.

Keywords: Colon surgery; Hip arthroplasty; Surgical site infections (SSIs); Surveillance programs.

MeSH terms

Aged
Arthroplasty, Replacement, Hip* / adverse effects
Colon
Cost of Illness
Disability-Adjusted Life Years
Hip Prosthesis* / adverse effects
Humans
Prospective Studies
Surgical Wound Infection / epidemiology
Surgical Wound Infection / etiology