Abstract
In France, surgical site infections (SSIs) are the second most frequent hospital-acquired infection. The study aimed to estimate the in-hospital clinical and economic burden of SSIs following 4 groups of surgeries. This retrospective observational study was based on the exhaustive national hospital database (PMSI. Adults with ≥1 digestive (colorectal or appendectomy), gynaecologic/obstetric (caesarean section, hysterectomy, or breast), cardiac (artery bypass or aortic valve replacement), or orthopaedic (hip or knee) surgery between 01-01-2019 and 30-11-2020 were included in the study. Patients with SSI were matched with patients without SSI. Patients were followed-up for 30 days except orthopaedic patients (90 days), according to clinical practice. A total of 240675, 331364, 52535, and 407823, patients with digestive, gynaecologic/obstetric, cardiac, and orthopaedic surgery were included. Respectively, 5.8%, 0.1%, 2.0%, and 1.0% of patients experienced an SSI, corresponding to 197.2, 3.4, 68.6, and 11.6 SSIs per 100000 patient-years. SSI patients stayed 13, 7, 15, and 20 extra days at the hospital, costing an extra EUR5246, EUR5363, EUR5725, and EUR11097 (National Health Insurance's perspective). The in-hospital mortality hazard ratios were 2.13, 7.24, 2.90, and 12.01 in SSI patients compared to patients without SSI. SSI greatly increases the risk of death, the length of stay and the hospital cost. Efforts to curtail SSI burden must be renewed.