An operating surveillance system of surgical site infections in the Netherlands: Results of the PREZIES National Surveillance Network

OBJCTIVES: To describe the results of the fir year of the Dutch national su rveillance of surgical-site infections (SSIs) and risk factors, which aims to implement a standardized surveillance system in a network of Dutch hospi tals, to collect comparable data on SSIs to serve as a reference, and to pr ovide a basic infrastructure for further intervention research. DESIGN: Prospective multicenter cohort study. SETTING: Acute-care hospitals in The Netherlands from June 1996 to May 1997 . RESULTS: 38 hospitals participated, with a slight over-representation of la rger hospitals. Following a total of 18,063 operations, 562 SSIs occurred, of which 198 were deep. Multivariate analysis of pooled procedures shows th at age, preoperative length of stay, wound contamination class, anesthesia score, and duration of surgery were independent risk factors for SSI. When analyzed by procedure, the relative importance of these risk factors change d. Bacteriological documentation was available for 56% of the SSIs; 35% of all isolates were Staphylococcus aureus. Multiple regression analysis compu ted the mean extra postoperative length of stay associated with SSI to be 8 .2 days. CONCLUSION: The first year of national surveillance has shown that it is fe asible to collect comparable data on SSI, which are already used for educat ion, policy, and decision making in the network of participating hospitals. This gives room to effectuate the next aim, namely to use the network as a n infrastructure for intervention research. Multivariate analysis shows tha t feedback on a procedure-specific level is important.