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Impact of surgical site infection after colorectal surgery on hospital stay and medical expenditure in Japan

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Abstract

Purpose

To clarify the impact of surgical site infection (SSI) after colorectal surgery on the length of hospital stay and medical expenditure in Japan.

Methods

This was a multi-center, retrospective-matched case–control study.

Results

The total number of patients enrolled was 334 (167 case/control pairs). The average hospital stay after surgery was prolonged by 17.8 days (95% CI 11.9–23.5) and the average medical cost after surgery was increased by $5,938 (95% CI 3,610–8,367) in the SSI group versus the non-SSI group. Hospital charges comprised the largest among all cost categories and accounted for 53% of the additional cost. The hospital stay and medical costs both increased proportionately to the depth of the SSI, from 4.4 days and $608 for superficial incisional SSI, to 39.2 days and $14,448 for organ/space SSI. SSI caused by MRSA prolonged the hospital stay by 19.3 days and incurred an additional cost of $7,015.

Conclusions

SSI clearly prolonged the hospital stay and increased medical costs. The numerical values revealed by this study reinforce the medical-economic importance of instigating preventive measures against SSI.

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Acknowledgments

We thank all physicians, healthcare information managers, and medical clerks who helped collaborate the patient data for this study. We also thank Akihiro Kishida MD, for his language advice.

Conflict of interest

Shinya Kusachi received lecture fees from Shionogi Phr. Co. Nobuichi Kashimura and the other co-authors have no conflict of interest.

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Authors and Affiliations

  1. Department of Surgery, Teine Keijinkai Hospital, 1-12 Maeda Teine-ku, Sapporo, 006-8555, Japan

    Nobuichi Kashimura

  2. Department of Surgery, Toho University, Medical Center Ohashi Hospital, Tokyo, Japan

    Shinya Kusachi

  3. Department of Surgery, NTT Medical Center Tokyo, Tokyo, Japan

    Toshiro Konishi

  4. Department of Surgery, Toyonaka Municipal Hospital, Toyonaka, Japan

    Junzo Shimizu

  5. Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Tsu, Japan

    Masato Kusunoki

  6. Department of Digestive Surgery and Surgical Oncology, Yamaguchi University Graduate School of Medicine, Ube, Japan

    Masaaki Oka

  7. Division of Surgical Oncology, Department of Surgery, Faculty of Medicine, Tottori University, Tottori, Japan

    Toshiro Wakatsuki

  8. Toho University, Tokyo, Japan

    Yoshinobu Sumiyama

Authors
  1. Nobuichi Kashimura
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  2. Shinya Kusachi
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  3. Toshiro Konishi
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  4. Junzo Shimizu
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  5. Masato Kusunoki
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  6. Masaaki Oka
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  7. Toshiro Wakatsuki
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  8. Yoshinobu Sumiyama
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Corresponding author

Correspondence to Nobuichi Kashimura.

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Kashimura, N., Kusachi, S., Konishi, T. et al. Impact of surgical site infection after colorectal surgery on hospital stay and medical expenditure in Japan. Surg Today 42, 639–645 (2012). https://doi.org/10.1007/s00595-012-0126-8

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  • DOI: https://doi.org/10.1007/s00595-012-0126-8

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