LONG-TERM PROGNOSIS OF PATIENTS WITH SURGICAL-WOUND INFECTIONS

This study examined if surgical wound infections (SWI) result in a sev ere prognosis regarding general health and increase the consumption of social resources. A group of 1301 patients were interviewed by self-a dministered questionnaires during 1993-1994, while operated during hos pitalization in seven Danish hospitals. These patients were followed u p at least once by similar questionnaires at a median time of 5.5 and 10.0 months postoperatively. The consequences of surgically diagnosed SWI were analyzed in a hospital cohort of 58 infected patients and 648 controls. Postdischarge infections were analyzed in a patient cohort of 263 cases and 767 controls. Changes in health was measured by the G eneral Health Questionnaire, Activities of Daily Living index, and sel f-assessed health. Consumption of resources were estimated by reliance on assistance from family and friends, use of home services, and cont acts to doctors. It was found that the long-term prognosis of general health was unaffected by SWIs. However significantly increased social dependence was found for patients with SWIs compared to uninfected pat ients. Almost one-fourth of the operations mere complicated by an SWI. Most of the infections were recognized only after discharge and were thought to be of minor importance, which may explain why no chronic im pairment of the health was found for patients-with an SWI. A bias towa rd no-effect may have been introduced if patients with severe SWIs abs tained from participation. The societal cost of care for patients with minor infections seems to be large. The causal relation between outco me and SWI needs to be further investigated.