Surgical Site Infections During the Pandemic: The Impact of the “COVID Bundle”
Background A reduction in surgical site infections (SSIs) has been reported in several discrete patient populations during the COVID-19 pandemic. Herein, this study evaluates the impact of the COVID-19 pandemic on SSI in a large patient cohort incorporating multiple surgical disciplines. We hypothes...
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| Veröffentlicht in: | World journal of surgery 2023-10, Vol.47 (10), p.2310-2318 |
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| container_title | World journal of surgery |
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| creator | McLoughlin, Louise Catherine Perlis, Nathan Lajkosz, Katherine Boasie, Alexandra Esmail, Tariq Nielson, Chantelle Lavrencic, Natalia Jackson, Timothy Kulkarni, Girish S. |
| description | Background
A reduction in surgical site infections (SSIs) has been reported in several discrete patient populations during the COVID-19 pandemic. Herein, this study evaluates the impact of the COVID-19 pandemic on SSI in a large patient cohort incorporating multiple surgical disciplines. We hypothesize that enhanced infection control and heightened awareness of such measures is analogous to an SSI care bundle, the hypothetical “COVID bundle”, and may impact SSI rates.
Method
Data collected for the American College of Surgeons National Surgical Quality Improvement Program between January 1, 2015, and April 1, 2021, were retrospectively analyzed. SSI rates were compared among time-dependent patient cohorts: Cohort A (pre-pandemic,
N
= 24,060, 87%) and Cohort B (pandemic,
N
= 3698, 13%). Time series and multivariable analyses predicted pre-pandemic and pandemic SSI trends and tested for association with timing of surgery.
Results
The overall SSI incidence was reduced in Cohort B versus Cohort A (2.8% vs. 4.5%,
p
|
| doi_str_mv | 10.1007/s00268-023-07112-3 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2841882260</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2859748765</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3779-43f19e43c742be8d0e1febe00fa239b0646951c4237935b059affa805774a34f3</originalsourceid><addsrcrecordid>eNqNkc1u1DAURi0EokPhBVigSGzYBK59nTjujk4pDKpUxBRYWo7nuqTKz9ROhLrrg7Qv1yfBbQpILBAr27rnu_p0zNhzDq85gHoTAURZ5SAwB8W5yPEBW3CJIhco8CFbAJYy3TnusCcxngFwVUL5mO2gklWFKBbs83oKp42zbbZuRspWvSc3NkMfs4MpNP1pNn6n7JPtN9Q1bi87Sa9Vt7VuzAZ_N7u5vFoef10dZPtTv2np5vL6KXvkbRvp2f25y74cvjtZfsiPjt-vlm-PcodK6Vyi55okOiVFTdUGiHuqCcBbgbqGUpa64E4KVBqLGgptvbcVFEpJi9LjLns1792G4XyiOJquiY7a1vY0TNGISvKqEqKEhL78Cz0bptCndokqdLKhyiJRYqZcGGIM5M02NJ0NF4aDuTVuZuMmGTd3xg2m0Iv71VPd0eZ35JfiBOzNwI-mpYv_WGm-fVzvH4KWXKcwzuG4vf0NCn-K_6PTT0d1mz8</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2859748765</pqid></control><display><type>article</type><title>Surgical Site Infections During the Pandemic: The Impact of the “COVID Bundle”</title><source>Wiley Online Library Journals Frontfile Complete</source><source>Springer Nature - Complete Springer Journals</source><creator>McLoughlin, Louise Catherine ; Perlis, Nathan ; Lajkosz, Katherine ; Boasie, Alexandra ; Esmail, Tariq ; Nielson, Chantelle ; Lavrencic, Natalia ; Jackson, Timothy ; Kulkarni, Girish S.</creator><creatorcontrib>McLoughlin, Louise Catherine ; Perlis, Nathan ; Lajkosz, Katherine ; Boasie, Alexandra ; Esmail, Tariq ; Nielson, Chantelle ; Lavrencic, Natalia ; Jackson, Timothy ; Kulkarni, Girish S.</creatorcontrib><description>Background
A reduction in surgical site infections (SSIs) has been reported in several discrete patient populations during the COVID-19 pandemic. Herein, this study evaluates the impact of the COVID-19 pandemic on SSI in a large patient cohort incorporating multiple surgical disciplines. We hypothesize that enhanced infection control and heightened awareness of such measures is analogous to an SSI care bundle, the hypothetical “COVID bundle”, and may impact SSI rates.
Method
Data collected for the American College of Surgeons National Surgical Quality Improvement Program between January 1, 2015, and April 1, 2021, were retrospectively analyzed. SSI rates were compared among time-dependent patient cohorts: Cohort A (pre-pandemic,
N
= 24,060, 87%) and Cohort B (pandemic,
N
= 3698, 13%). Time series and multivariable analyses predicted pre-pandemic and pandemic SSI trends and tested for association with timing of surgery.
Results
The overall SSI incidence was reduced in Cohort B versus Cohort A (2.8% vs. 4.5%,
p
< 0.001). Multivariable analysis indicated a downward SSI trend before pandemic onset (IRR 0.997, 95% CI 0.994, 1). At pandemic onset, the trend reduced by a relative factor of 39% (IRR 0.601, 95% CI 0.338, 1.069). SSI then trended upward during the pandemic (IRR 1.035, 95% CI 0.965, 1.111). SSI rates significantly trended downward in general surgical patients at pandemic onset (IRR 0.572, 95% CI 0.353, 0.928).
Conclusion
Although overall SSI incidence was reduced during the pandemic, a statistically significant decrease in the predicted SSI rate only occurred in general surgical patients at pandemic onset. This trend may suggest a positive impact of the “COVID bundle” on SSI rates in these patients.</description><identifier>ISSN: 0364-2313</identifier><identifier>EISSN: 1432-2323</identifier><identifier>DOI: 10.1007/s00268-023-07112-3</identifier><identifier>PMID: 37488332</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Abdominal Surgery ; Cardiac Surgery ; COVID-19 ; General Surgery ; Infectious diseases ; Medicine ; Medicine & Public Health ; Original Scientific Report ; Pandemics ; Patients ; Quality control ; Statistical analysis ; Surgery ; Surgical site infections ; Thoracic Surgery ; Time dependence ; Trends ; Vascular Surgery</subject><ispartof>World journal of surgery, 2023-10, Vol.47 (10), p.2310-2318</ispartof><rights>The Author(s) under exclusive licence to Société Internationale de Chirurgie 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023 The Author(s) under exclusive licence to Société Internationale de Chirurgie</rights><rights>2023. The Author(s) under exclusive licence to Société Internationale de Chirurgie.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3779-43f19e43c742be8d0e1febe00fa239b0646951c4237935b059affa805774a34f3</cites><orcidid>0000-0001-8229-9197</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00268-023-07112-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00268-023-07112-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,41467,42536,45553,45554,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37488332$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>McLoughlin, Louise Catherine</creatorcontrib><creatorcontrib>Perlis, Nathan</creatorcontrib><creatorcontrib>Lajkosz, Katherine</creatorcontrib><creatorcontrib>Boasie, Alexandra</creatorcontrib><creatorcontrib>Esmail, Tariq</creatorcontrib><creatorcontrib>Nielson, Chantelle</creatorcontrib><creatorcontrib>Lavrencic, Natalia</creatorcontrib><creatorcontrib>Jackson, Timothy</creatorcontrib><creatorcontrib>Kulkarni, Girish S.</creatorcontrib><title>Surgical Site Infections During the Pandemic: The Impact of the “COVID Bundle”</title><title>World journal of surgery</title><addtitle>World J Surg</addtitle><addtitle>World J Surg</addtitle><description>Background
A reduction in surgical site infections (SSIs) has been reported in several discrete patient populations during the COVID-19 pandemic. Herein, this study evaluates the impact of the COVID-19 pandemic on SSI in a large patient cohort incorporating multiple surgical disciplines. We hypothesize that enhanced infection control and heightened awareness of such measures is analogous to an SSI care bundle, the hypothetical “COVID bundle”, and may impact SSI rates.
Method
Data collected for the American College of Surgeons National Surgical Quality Improvement Program between January 1, 2015, and April 1, 2021, were retrospectively analyzed. SSI rates were compared among time-dependent patient cohorts: Cohort A (pre-pandemic,
N
= 24,060, 87%) and Cohort B (pandemic,
N
= 3698, 13%). Time series and multivariable analyses predicted pre-pandemic and pandemic SSI trends and tested for association with timing of surgery.
Results
The overall SSI incidence was reduced in Cohort B versus Cohort A (2.8% vs. 4.5%,
p
< 0.001). Multivariable analysis indicated a downward SSI trend before pandemic onset (IRR 0.997, 95% CI 0.994, 1). At pandemic onset, the trend reduced by a relative factor of 39% (IRR 0.601, 95% CI 0.338, 1.069). SSI then trended upward during the pandemic (IRR 1.035, 95% CI 0.965, 1.111). SSI rates significantly trended downward in general surgical patients at pandemic onset (IRR 0.572, 95% CI 0.353, 0.928).
Conclusion
Although overall SSI incidence was reduced during the pandemic, a statistically significant decrease in the predicted SSI rate only occurred in general surgical patients at pandemic onset. This trend may suggest a positive impact of the “COVID bundle” on SSI rates in these patients.</description><subject>Abdominal Surgery</subject><subject>Cardiac Surgery</subject><subject>COVID-19</subject><subject>General Surgery</subject><subject>Infectious diseases</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Scientific Report</subject><subject>Pandemics</subject><subject>Patients</subject><subject>Quality control</subject><subject>Statistical analysis</subject><subject>Surgery</subject><subject>Surgical site infections</subject><subject>Thoracic Surgery</subject><subject>Time dependence</subject><subject>Trends</subject><subject>Vascular Surgery</subject><issn>0364-2313</issn><issn>1432-2323</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkc1u1DAURi0EokPhBVigSGzYBK59nTjujk4pDKpUxBRYWo7nuqTKz9ROhLrrg7Qv1yfBbQpILBAr27rnu_p0zNhzDq85gHoTAURZ5SAwB8W5yPEBW3CJIhco8CFbAJYy3TnusCcxngFwVUL5mO2gklWFKBbs83oKp42zbbZuRspWvSc3NkMfs4MpNP1pNn6n7JPtN9Q1bi87Sa9Vt7VuzAZ_N7u5vFoef10dZPtTv2np5vL6KXvkbRvp2f25y74cvjtZfsiPjt-vlm-PcodK6Vyi55okOiVFTdUGiHuqCcBbgbqGUpa64E4KVBqLGgptvbcVFEpJi9LjLns1792G4XyiOJquiY7a1vY0TNGISvKqEqKEhL78Cz0bptCndokqdLKhyiJRYqZcGGIM5M02NJ0NF4aDuTVuZuMmGTd3xg2m0Iv71VPd0eZ35JfiBOzNwI-mpYv_WGm-fVzvH4KWXKcwzuG4vf0NCn-K_6PTT0d1mz8</recordid><startdate>202310</startdate><enddate>202310</enddate><creator>McLoughlin, Louise Catherine</creator><creator>Perlis, Nathan</creator><creator>Lajkosz, Katherine</creator><creator>Boasie, Alexandra</creator><creator>Esmail, Tariq</creator><creator>Nielson, Chantelle</creator><creator>Lavrencic, Natalia</creator><creator>Jackson, Timothy</creator><creator>Kulkarni, Girish S.</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8229-9197</orcidid></search><sort><creationdate>202310</creationdate><title>Surgical Site Infections During the Pandemic: The Impact of the “COVID Bundle”</title><author>McLoughlin, Louise Catherine ; Perlis, Nathan ; Lajkosz, Katherine ; Boasie, Alexandra ; Esmail, Tariq ; Nielson, Chantelle ; Lavrencic, Natalia ; Jackson, Timothy ; Kulkarni, Girish S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3779-43f19e43c742be8d0e1febe00fa239b0646951c4237935b059affa805774a34f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Abdominal Surgery</topic><topic>Cardiac Surgery</topic><topic>COVID-19</topic><topic>General Surgery</topic><topic>Infectious diseases</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Scientific Report</topic><topic>Pandemics</topic><topic>Patients</topic><topic>Quality control</topic><topic>Statistical analysis</topic><topic>Surgery</topic><topic>Surgical site infections</topic><topic>Thoracic Surgery</topic><topic>Time dependence</topic><topic>Trends</topic><topic>Vascular Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>McLoughlin, Louise Catherine</creatorcontrib><creatorcontrib>Perlis, Nathan</creatorcontrib><creatorcontrib>Lajkosz, Katherine</creatorcontrib><creatorcontrib>Boasie, Alexandra</creatorcontrib><creatorcontrib>Esmail, Tariq</creatorcontrib><creatorcontrib>Nielson, Chantelle</creatorcontrib><creatorcontrib>Lavrencic, Natalia</creatorcontrib><creatorcontrib>Jackson, Timothy</creatorcontrib><creatorcontrib>Kulkarni, Girish S.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>World journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>McLoughlin, Louise Catherine</au><au>Perlis, Nathan</au><au>Lajkosz, Katherine</au><au>Boasie, Alexandra</au><au>Esmail, Tariq</au><au>Nielson, Chantelle</au><au>Lavrencic, Natalia</au><au>Jackson, Timothy</au><au>Kulkarni, Girish S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Surgical Site Infections During the Pandemic: The Impact of the “COVID Bundle”</atitle><jtitle>World journal of surgery</jtitle><stitle>World J Surg</stitle><addtitle>World J Surg</addtitle><date>2023-10</date><risdate>2023</risdate><volume>47</volume><issue>10</issue><spage>2310</spage><epage>2318</epage><pages>2310-2318</pages><issn>0364-2313</issn><eissn>1432-2323</eissn><abstract>Background
A reduction in surgical site infections (SSIs) has been reported in several discrete patient populations during the COVID-19 pandemic. Herein, this study evaluates the impact of the COVID-19 pandemic on SSI in a large patient cohort incorporating multiple surgical disciplines. We hypothesize that enhanced infection control and heightened awareness of such measures is analogous to an SSI care bundle, the hypothetical “COVID bundle”, and may impact SSI rates.
Method
Data collected for the American College of Surgeons National Surgical Quality Improvement Program between January 1, 2015, and April 1, 2021, were retrospectively analyzed. SSI rates were compared among time-dependent patient cohorts: Cohort A (pre-pandemic,
N
= 24,060, 87%) and Cohort B (pandemic,
N
= 3698, 13%). Time series and multivariable analyses predicted pre-pandemic and pandemic SSI trends and tested for association with timing of surgery.
Results
The overall SSI incidence was reduced in Cohort B versus Cohort A (2.8% vs. 4.5%,
p
< 0.001). Multivariable analysis indicated a downward SSI trend before pandemic onset (IRR 0.997, 95% CI 0.994, 1). At pandemic onset, the trend reduced by a relative factor of 39% (IRR 0.601, 95% CI 0.338, 1.069). SSI then trended upward during the pandemic (IRR 1.035, 95% CI 0.965, 1.111). SSI rates significantly trended downward in general surgical patients at pandemic onset (IRR 0.572, 95% CI 0.353, 0.928).
Conclusion
Although overall SSI incidence was reduced during the pandemic, a statistically significant decrease in the predicted SSI rate only occurred in general surgical patients at pandemic onset. This trend may suggest a positive impact of the “COVID bundle” on SSI rates in these patients.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>37488332</pmid><doi>10.1007/s00268-023-07112-3</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-8229-9197</orcidid></addata></record> |
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| ispartof | World journal of surgery, 2023-10, Vol.47 (10), p.2310-2318 |
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| language | eng |
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| source | Wiley Online Library Journals Frontfile Complete; Springer Nature - Complete Springer Journals |
| subjects | Abdominal Surgery Cardiac Surgery COVID-19 General Surgery Infectious diseases Medicine Medicine & Public Health Original Scientific Report Pandemics Patients Quality control Statistical analysis Surgery Surgical site infections Thoracic Surgery Time dependence Trends Vascular Surgery |
| title | Surgical Site Infections During the Pandemic: The Impact of the “COVID Bundle” |
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