The Economic Costs of Surgical Site Infection

Abstract

Background: Surgical site infections (SSIs) remain common and are a major cause of postoperative morbidity. Less well recognized is the cost of these complications, both in the direct costs of care and also in terms of lost economic productivity when workers are disabled as a result of an infection. This review was undertaken to bring into focus the relevant literature regarding the costs associated with SSI. Methods: Review of the pertinent English language literature. Results: The estimated costs of SSI vary as a function of locale, type of operation, and the extent (depth) of the infection itself. Superficial SSIs cared for in the National Health Service of the United Kingdom have an estimated cost of less that $400/case, whereas estimates range into the tens of thousands of dollars per case in the United States for complex infections such as infected joint prostheses or sternal infections following cardiac surgery. The magnitude of the problem is emphasized by a report from Denmark, which shows that the cost of care for surgical site infections consumes 0.5% of the annual hospital budget. Conclusion: SSI is morbid and expensive. However, not all SSIs are the same. Reports of economic costs that do not stratify for the depth of the infection or the context in which the infection occurs are potentially misstating the magnitude of these complications.