Heightened Vigilance

By identifying patients at high risk of SSIs, health systems can take the necessary precautions to reduce the chance of infection.

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With surgical site infections (SSIs) on the rise, as well as the financial cost of treating them, finding evidence-based strategies to prevent infections for hospitals and health systems is critical. One of those evidence-based strategies involves identifying patients who may be more at risk of SSIs.

Diabetic patients in particular are at a “considerably” increased risk for developing surgical site infections (SSIs) while undergoing most types of surgeries, compared to non-diabetic patients, according to a study published in Infection Control & Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America (SHEA).

“Diabetes has been recognized as a risk factor for infection following some surgeries, but has been a source of debate for other procedures,” said Emily Toth Martin, PhD, lead author of the 2015 study and assistant professor of epidemiology at the University of Michigan School of Public Health.

The researchers conducted a systematic review and meta-analysis spanning 94 studies published between 1985 and 2015, and analyzed data based on estimates of diabetes, SSIs, types of procedure, blood glucose levels and body mass index. They found that diabetic patients undergoing surgery were 50% more likely to develop an SSI compared to patients without diabetes (6% vs. 4%). Previous studies had found increased risk for diabetic patients during several types of surgery, but the new research confirmed that a broader range of procedures had elevated risk of SSIs, including arthroplasty, breast, cardiac and spinal surgeries.

“Hospitals routinely monitor glucose levels in surgical patients, but heightened awareness among healthcare professionals of infection prevention measures is warranted for diabetic patients before and after surgery,” said Martin.

Facts about SSIs

According to the CDC, a surgical site infection (SSI) is an infection that occurs after surgery in the part of the body where the surgery took place. Surgical site infections can sometimes be superficial infections involving the skin only. Other surgical site infections are more serious and can involve tissues under the skin, organs, or implanted material.

SSIs occur in 2% to 4% of all patients undergoing inpatient surgical procedures, according to data from the Agency for Healthcare Research and Quality. Although most infections are treatable with antibiotics, SSIs remain a significant cause of morbidity and mortality after surgery. They are the leading cause of readmissions to the hospital following surgery, and approximately 3% of patients who contract an SSI will die as a consequence. Although SSIs are less common following ambulatory surgery than after inpatient procedures, they are a frequent source of morbidity in these patients as well.

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