Postdischarge surveillance: The impact on surgical site infection incidence in a Brazilian university hospital

Objective This prospective cohort study was carried out in a surgical unit of a university hospital in Brazil. The purpose of the study was to determine the incidence of surgical site infection (SSI) in patients during hospitalization and after discharge from the hospital. Method In a sample of 630 patients who underwent surgical procedures, association among diagnosis of SSI (in-hospital or postdischarge), class of the surgery (elective or emergency), hospitalization period, patientʹs clinical condition (American Society of Anesthesiologists [ASA] score), classification of surgical site, and duration of surgical procedure were verified. Results Fifty SSIs were diagnosed while the patients were still in the hospital, and 140 postdischarge. Hospitalization periods >5 days and worse clinical condition (ASA III) were associated with a higher SSI incidence. Classification of SSI was not correlated to the incidence of in-hospital SSI, except for clean surgeries. Surgical procedures of >5 hours duration were correlated to SSI during hospitalization, and procedures of >2 hours duration correlated to a postdischarge SSI. Most SSIs (73.7%) were diagnosed postdischarge. Conclusion Results show a high incidence of postsurgical infection detected during postdischarge surveillance, which suggests the need for postdischarge follow-ups for surgical patients.