De frequentie van postoperatieve wondinfecties: een ongeschikte parameter om ziekenhuizen te vergelijken

To evaluate the reliability of registration of wound infections and their contribution to total postoperative morbidity.

Design

Prospective.

Method

During the period from 1 July 1997 through 30 June 1998 of all patients treated in the department of Surgery of the Diaconessen Hospital, Utrecht, the treatment-related complications were recorded during the hospital stay as well as at the first outpatient follow-up. The clinical registration forms were checked and supplemented after discharge, during the transfer and by the hospital hygienist. The precision of registration, the implications of the registered wound infections, and the share of this complication in overall postoperative morbidity were studied.

Results

There were 2172 admissions (2004 patients): 996 males and 1176 females (mean age at admission 55 years). The response of registration was 100 during hospital stay and 59.5 in the outpatient department. Postoperative course was complicated in 506 patients (23 of the admissions). Of the 735 registered complications 583 (79) were recorded during clinical stay. Airway and wound infections were the most frequently registered complications (in 4.4 and 4.3 of the admissions respectively). Of the wound infections 45 were recorded after discharge and 88 fully recovered by conservative means. Both the frequency of wound infections in relation to other postoperative complications and the severity of the registered wound infections varied with the reason of admission.

Conclusion

The incidence of postoperative wound infections was not reliably measured as a result of low response of registration after hospital discharge. The contribution of wound infections to overall postoperative morbidity and the severity of these infections varied with the reason of admission.