Surgical patients with methicilIin resistant staphylococcus aureus infection: an analysis of outcome using P-POSSUM

The significance of MRSA infection in surgical patients was studied using t he P-POSSUM scoring system. All surgical patients undergoing operation betw een 1/10/96 and 30/09/97 were prospectively scored using P-POSSUM. A subset of these patients with MRSA infection was analysed using P-POSSUM predicte d mortality, Physiological and operative severity scores were compared with non-MRSA surgical patients and length of hospital stay with P-POSSUM match ed non-MRSA controls, Thirty of the 1132 patients were MRSA positive and of these five died, giving a P-POSSUM observed/expected deaths ratio of 1.7 ( not significant; 95% CI -0.24 to 0.10). The P-POSSUM physiology score of 30 MRSA positive patients, compared with the non-MRSA group (n=1102), was sig nificantly more severe (20.9 v/s 17.4; 95% CI 1.09 to 5.95) as was the oper ative severity score (15.6 vis 9.2; 95% CI 4.40 to 8.42). The length of sta y for surviving MRSA positive patients was significantly longer than P-POSS UM matched controls. MRSA infection in surgical patients does not increase mortality However, patients who contract MRSA infection are more debilitate d and have undergone a greater surgical insult.