25 March 2024: Clinical Research
Effect of Standardized Bundle Care and Bundle Compliance on Reducing Surgical Site Infections: A Pragmatic Retrospective Cohort Study
Yu-san Chien 12CDEF , Hsiang-ting Chen 3BC , Hsiu-tzy Chiang 4BC , Tz-shin Luo 5EF , Hung-i Yeh 6AD , Jin-Cherng Sheu 7AF , Jiun-yi Li 235ABCD*DOI: 10.12659/MSM.943493
Med Sci Monit 2024; 30:e943493
Table 1 Comparison of characters and clinical outcomes of pre-bundle group and post-bundle group.
| All patients (N=6059) | Pre-bundle (N=2010) | Post-bundle (N=4049) | p-value | |
|---|---|---|---|---|
| Age (years) | 50.9±17.0 | 42.8±15.5 | 54.9±16.3 | |
| Male (%) | 29.0% | 25.3% | 30.8% | |
| BMI (kg/m) | 25.9±4.5 | 26.4±4.5 | 25.6±4.5 | 0.384 |
| Smoking (%) | 15.7% | 13.8% | 16.7% | 0.002 |
| Diabetes (%) | 13.9% | 11.9% | 15.0% | 0.001 |
| ASA score III–V (%) | 23.7% | 20.7% | 25.5% | |
| Emergent operation (%) | 13.2% | 19.1% | 10.2% | |
| Duration of anesthesia(min) | 173.0±99.4 | 148.9±104.8 | 185.0±94.4 | 0.928 |
| Duration of operation (min) | 136.8±88.7 | 116.9±93.1 | 146.6±84.8 | 0.159 |
| Operation time ≥4 hours (%) | 12.4% | 10.6% | 13.3% | 0.001 |
| Blood loss ≥1500cc (%) | 0.7% | 0.3% | 0.8% | 0.008 |
| Antibiotics | ||||
| – Prophylaxis (%) | 82.8% | 78.4% | 85.0% | |
| – Adequate redosing (%) | 99.0% | 99.4% | 98.8% | 0.03 |
| – Duration of post-operative antibiotics (days) | 1.5±1.8 | 2.2±2.7 | 1.3±1.5 | |
| Glycemic control | ||||
| – Pre-operative >180mg/dL (%) | 5.3% | 15.0% | 3.7% | |
| – Post-operative >180 mg/dL | ||||
| Day 1 (%) | 19.7% | 36.1% | 17.4% | |
| Day 2 (%) | 26.5% | 40.0% | 25.3% | 0.007 |
| Pre-operative skin preparation | ||||
| – Bath (%) | 43.7% | 15.3% | 58.0% | |
| – Clipper use (%) | 32.8% | 0.2% | 64.7% | |
| Adequate temperature control (%) | 76.9% | 78.0% | 76.6% | 0.231 |
| Incidence of SSI | 1.2% | 1.7% | 1.0% | 0.013 |
| SIR | 0.98 | 1.48 | 0.80 | |
| Unexpected return to OR (%) | 0.1% | 0% | 0.2% | 0.198 |
| Post-operative hospital stay (days) | 5.7±7.1 | 5.7±7.7 | 5.7±6.8 | 0.533 |
| Total hospital stay (days) | 7.4±9.3 | 7.5±10.3 | 7.3±8.7 | 0.057 |
| Survival to discharge (%) | 99.4% | 99.4% | 99.5% | 0.818 |
| BMI – body mass index; ASA score – American Society of Anesthesiologists’ (ASA) physical status classification score; SSI – Surgical Site Infection; SIR – Standardized Infection Ratio; OR – operating room. | ||||