Admissions for post-discharge surgical site infection at a quaternary South African public sector hospital

Abstract

Background: Reports of post-discharge admissions for surgical site infection (SSI) in African settings are lacking. This information could assist with allocating resources within hospitals, as well as developing targeted interventions aimed at reducing post-discharge SSI. The primary objective of this study was to determine trends in admissions for post-discharge SSI at a South African quaternary/teaching hospital. The secondary objective was to determine trends in mortality rates for these admissions. Methods: This was a retrospective review of adult admissions for post-discharge SSI at a quaternary/teaching South African hospital between 2006 and 2015. Admissions for post-discharge SSI were identified using the hospital administrative database and appropriate International Classification of Disease, 10th Revision codes. Mortality was determined from the discharge disposition for each admission. Data were analysed with simple regression and trend line statistics. The geospatial distribution of post-discharge SSI, based on the residential postal codes recorded on the hospital administrative database for each admission, was determined using the Power Map® software program. Results: There was no change in admissions for post-discharge SSI over the study period (p = 0.17). Mortality in elderly admissions declined during the study period (p = 0.03). Most admissions for post-discharge SSIs originated from urban areas. Conclusion: Despite the implementation of universal SSI prevention methods, admissions for post-discharge SSI remained consistent during the study period. Urban areas appeared to be more severely affected by post-discharge SSI than rural areas. Additional prevention methods for post-discharge SSI are required.