SSI Rates: Hospitals vs. ASCs, 2010

The recent revelation that national surgical site infection rates in ASCs nationwide remain low may not come as a surprise for some. After all, one of the purported benefits of receiving surgery outside of a hospital setting is that it has the potential to be safer and cleaner. How exactly to hospitals measure up to ASCs when it comes to SSIs?

Data from the Centers for Disease Control and Prevention shows that of 529,038 patients who underwent procedures of 10 varieties* recorded in National Healthcare Safety Network data in 2010, 4,737 patients, or approximately 8.95 per 1000 patients, developed an SSI.

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In contrast, an analysis of 2010 data on SSI rates in ASCs, released this week in Journal of the American Medical Association, found that 4.84 per 1000 patients who had ambulatory surgery went on to develop an SSI requiring inpatient treatment within 30 days after surgery, though two-thirds of these developed the SSI within 14 days after surgery.

In general, CDC-NHSN data has shown outpatient surgery consistently outperforms inpatient surgery in terms of pure infection rates.

CDC now reports SSI data as a standardized infection ratio from a baseline comparison year. The agency has stated it is inadvisable to compare SSI rates for different types of hospitals performing different complements of procedures. In addition, SIRs facilitate benchmarking efforts through determining infection reduction from a baseline year.

According to a 2013 analysis published in Infection Control and Hospital Epidemiology, comparing CDC-NHSN data to data from the 30-country International Nosocomial Infection Control Consortium found international inpatient SSI rates are somewhat higher than their US counterparts, with aggregated SSI rates for 31 procedures measured between 2005 and 2010 at 2.9 percent, or 29 per 1000 patients.

*The 2010 NHSN SSI data was collected for hip arthroplasty, knee arthroplasty, coronary artery bypass graft, cardiac, peripheral vascular bypass, abdominal aortic aneurysm repair, colon, rectal, abdominal hysterectomy and vaginal hysterectomy surgeries.

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