Surgical site infections in patients who undergo radical cystectomy: Excess mortality, stay prolongation and hospital cost overruns

Abstract

BackgroundThe aim of this study was to analyze the impact of surgical site infections (SSI) in patients who underwent radical cystectomy, in terms of excess hospital mortality, stay prolongation and cost overruns. Material and methodsA retrospective observational study was conducted on a sample of patients who underwent radical cystectomy as recorded in the basic minimum data sets of 87 Spanish hospitals from 2008 to 2010. ResultsWe studied 4377 patients who underwent radical cystectomy (3904 men and 473 women) of whom 849 (19.4%) experienced a SSI. The patients with SSI were predominantly men, elderly and had a higher prevalence of alcohol-related disorders and more number of comorbidities. The patients with SSI had significant excess mortality (125.6%), undue stay prolongation (17.8 days) and cost overruns (14,875.70 euros). ConclusionsAfter controlling for demographic variables, hospital type, addiction disorders and comorbidities using multivariate pairing, the onset of SSI in patients who underwent radical cystectomy significantly increased the mortality, stay and cost. Certain preventive measures already established in previous studies could reduce the incidence of SSI and its healthcare and financial impact.