Hospital-Associated Costs Due to Surgical Site Infection After Breast Surgery
Olsen MA, Chu-Ongsakul S, Brandt KE, Dietz JR, Mayfield J, Fraser VJ
Arch Surg. 2008;143:53-60
Summary
The aim of this study, which was conducted in a single hospital, was to determine the frequency and associated costs arising from a surgical wound infection after breast surgery. During the study period, 50 of the 949 women undergoing breast surgery (5.3%) developed a wound infection in the year immediately after the operation. Median time interval from surgery to diagnosis of wound infection was 25 days, and in only 2 patients was the wound infection diagnosed during the initial hospitalization. Infection rates were higher if the patient underwent an implant. The estimated cost for a wound infection after adjusting for type of surgery, disease stage, and other variables was about $4000 (95% confidence interval $2800-$5500).
Viewpoint
The infection rate determined by the study authors was considerably higher than the 2% rate reported by the US Centers for Disease Control and Prevention (CDC). This is understandable because most of the infections in this study were diagnosed after the patient had been discharged. Infection rates differed depending on the type of surgery; there was no information about the influence of adjuvant therapy on infection rates. The estimated excess cost attributable to infection, roughly $4000, excludes nonhospital costs, such as physician and any additional outpatient costs. The true cost would be considerably higher.
Reviewed by Dr. Ramaz Mitaishvili
