Surgical site infection after gastrointestinal surgery in children : an international, multicentre, prospective cohort study

Show simple item record GlobalSurg Collaborative Drake, Thomas M. Tolonen, Matti Leppäniemi, Ari Sallinen, Ville Sund, Malin 2021-01-15T06:51:01Z 2021-01-15T06:51:01Z 2020
dc.identifier.citation GlobalSurg Collaborative , Drake , T M , Tolonen , M , Leppäniemi , A , Sallinen , V & Sund , M 2020 , ' Surgical site infection after gastrointestinal surgery in children : an international, multicentre, prospective cohort study ' , BMJ global health , vol. 5 , no. 12 , 003429 .
dc.identifier.other PURE: 159036901
dc.identifier.other PURE UUID: df7b7efb-3ce3-46d3-8b78-2317b21fccbe
dc.identifier.other WOS: 000598727100006
dc.identifier.other ORCID: /0000-0002-7516-9543/work/109266620
dc.description.abstract Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). Results Of 1159 children across 181 hospitals in 51 countries, 523 (45 center dot 1%) children were from high HDI, 397 (34 center dot 2%) from middle HDI and 239 (20 center dot 6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12 center dot 8% (51/397) in middle HDI and 24 center dot 7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda. en
dc.format.extent 14
dc.language.iso eng
dc.relation.ispartof BMJ global health
dc.rights cc_by
dc.rights.uri info:eu-repo/semantics/openAccess
dc.subject gastro-enterologic surgery
dc.subject paediatrics
dc.subject GLOBAL BURDEN
dc.subject AFRICA
dc.subject 3142 Public health care science, environmental and occupational health
dc.subject 3126 Surgery, anesthesiology, intensive care, radiology
dc.title Surgical site infection after gastrointestinal surgery in children : an international, multicentre, prospective cohort study en
dc.type Article
dc.contributor.organization HUS Abdominal Center
dc.contributor.organization II kirurgian klinikka
dc.contributor.organization Department of Anatomy
dc.contributor.organization Pertti Panula / Principal Investigator
dc.contributor.organization Clinicum
dc.description.reviewstatus Peer reviewed
dc.relation.issn 2059-7908
dc.rights.accesslevel openAccess
dc.type.version publishedVersion

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