RESUMO
OBJECTIVES: To detect the occurrence of surgical-site infection (SSI) in our study sample, using the traditional variables of the National Nosocomial Infection Surveillance (NNIS) index with a locally modified cut-off point for the "T time" defining length of surgical procedure; to compare the modified and the traditional NNIS index under the hypothesis that a cut-off point discriminating procedures of short and long duration, based upon the actual experience of the study sample, can adequately predict the risk of SSI. DESIGN: A retrospective chart review of 9,322 patients undergoing surgical procedures in the period January 1993 to December 1998. SETING: A small university hospital (UH) in southern Brazil. RESULTS: The composite index using the local sample procedure-duration cut-off point (UH-index) performed better than any of the individual components of the composite index (anesthesia risk index and surgical-wound class [SWC]). The UH-index also predicted adequately the risk of SSI when compared to the traditional NNIS index, particularly when stratifying by SWC. CONCLUSIONS: A modified NNIS index, using the sample cut-off point, can adequately predict the risk of SSI in a given population. Further studies are needed to compare and validate the NNIS index of risk for populations other than those of the NNIS-participating hospitals. Larger samples using different hospitals with similar characteristics are needed to investigate the risk of SSI associated with specific operations.
Assuntos
Infecção Hospitalar/epidemiologia , Infecção da Ferida Cirúrgica/epidemiologia , Brasil/epidemiologia , Feminino , Hospitais Universitários , Humanos , Incidência , Masculino , Vigilância da População , Estudos Retrospectivos , Medição de Risco , Fatores de RiscoRESUMO
OBJETIVO: Investigar a aplicabilidade da metodologia do sistema NNIS em um hospital universitário brasileiro, por meio da avaliaçäo do modelo preditivo de ISC que deu origem ao índice de medida de risco intrínseco. CASUISTICA E MÉTODO: Foi conduzida uma revisäo retrospectiva dos prontuários de 9.322 pacientes submetidos a procedimento cirúrgico no período de janeiro de 1993 a dezembro de 1998. Os dados foram coletados utilizando a opçäo detalhada do componente de vigilância do paciente cirúrgico do sistema NNIS. Foi calculada a incidência de ISC de acordo com as diferentes categorias individuais dos componentes do índice de risco NNIS (Classe de Ferida, escore ASA e duraçäo da cirurgia). A força da associaçäo entre cada um destes fatores e a ocorrência de ISC foi medida pelo coeficiente Gamma de Goodman-Kruskal (G). RESULTADOS: O escore ASA mostrou-se o melhor preditor de ISC entre os componentes individuais do índice de risco (G=0.49). O índice composto mostrou ser um melhor preditor de ISC do que classe de ferida e teve um poder preditivo semelhante ao do ASA (G=0.50). CONCLUSÕES: O grau de associaçäo entre o índice NNIS e a ocorrência de ISC encontrada no presente estudo está em consonância com os resultados relatados por outros autores e mostrou-se adequado para a avaliaçäo do risco de infecçäo cirúrgica em nossos pacientes. Amostras utilizando diferentes hospitais com características semelhantes säo necessárias para avaliar o risco associado com procedimentos cirúrgicos específicos
Assuntos
Humanos , Infecção da Ferida Cirúrgica/epidemiologia , Infecção Hospitalar/epidemiologia , Procedimentos Cirúrgicos Operatórios , Brasil/epidemiologia , Vigilância da População , Estudos Retrospectivos , Medição de Risco , Estudo de AvaliaçãoRESUMO
BACKGROUND: The NNIS risk index has been largely recommended because it consists of a simple additive scale. Nevertheless, it has been seldom validated in populations other than the NNIS participating hospitals OBJECTIVES: To investigate the occurrence of Surgical Site Infection ( SSI ) using the traditional variables of the NNIS Index, and to approach the suitability of this methodology when applied to a smaller public university hospital (HU/UFSC) in Florianópolis, South Brazil. METHODS: A retrospective chart review of 9322 patients undergoing surgical procedures in the period of January 1993 to December 1998. RESULTS: The composite index showed to be a better predictor of SSI than Surgical Wound class (SWc) and presented a predictive power comparable to the ASA index. ASA together with length of surgery seemed to be the main contributors for the final performance of the composite index. CONCLUSIONS: The composite index using the variables of the traditional NNIS system showed to adequately predict the risk of SSI in our university hospital. Larger samples using different hospitals with similar characteristics are needed to approach the risk of SSI associated to specific surgical procedures.
Assuntos
Infecção Hospitalar/epidemiologia , Vigilância da População , Infecção da Ferida Cirúrgica/epidemiologia , Brasil/epidemiologia , Humanos , Estudos Retrospectivos , Medição de RiscoRESUMO
The authors propose a method for the control of the consumption material supplied by the stock room in and attempt to rationalize the work, reduce costs and control problems of damage and disappearance, as well as the quality of the material. They also suggest that distribution and control should be carried out by administrative personnel, trained for such purpose. Preparatory to inception, the authors propose standardization of the material, setting of an average level of consumption according to the material type, and the study and analysis of those activities associated with the distribution and control of above mentioned material.