Orthopedic specialty hospitals are associated with lower rates of surgical site infection
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Compared with tertiary care institutions, orthopedic specialty hospitals are associated with lower rates of deep surgical site infection at 1 year, according to published results.
Michael Yayac, MD, and colleagues from Rothman Orthopaedic Institute at Thomas Jefferson University analyzed data on 20,264 patients who underwent surgery at a tertiary hospital and 7,169 patients who underwent surgery at a specialty hospital from 2010 to 2017.
According to the study, procedure type included total hip (39.4%), knee (36%) and shoulder arthroplasty (17.7%), as well as single-level lumbar fusion (6.9%). The primary outcome measure was the development of deep surgical site infection (SSI) within 1 year of the index procedure.
Yayac and colleagues found 0.6% of patients (n = 116) who underwent surgery at a tertiary hospital and 0.2% (n = 12) of patients who underwent surgery at a specialty hospital had a 1-year incidence of deep SSI. The highest incidence of 1-year deep SSI was found in patients who underwent single-level lumbar fusion at a tertiary hospital (1.6%, n = 23 patients).
Multivariate analysis revealed that patients undergoing surgery at a specialty hospital were at significantly lower risk for infection compared with patients undergoing surgery at a tertiary hospital; however, after controlling for a healthier patient population, researchers discovered that procedures performed at a specialty hospital were independent predictors of infection within 1 year.
“Although tertiary hospitals care for older patients with more medical comorbidities, patients undergoing orthopedic procedures at a specialty hospital may be at lower risk for infection,” the researchers wrote in the study. “Further study is needed to identify the processes associated with reduced infection rates and to determine whether they can be adopted at tertiary centers,” they added.
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