{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T05:03:05Z","timestamp":1793250185048,"version":"4.5.0"},"reference-count":35,"publisher":"Cambridge University Press (CUP)","issue":"12","license":[{"start":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T00:00:00Z","timestamp":1760400000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec id=\"S0899823X25103218_as1\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Surgical site infections (SSIs) are among the most common postoperative complications in colorectal surgery, and associate with increased morbidity, prolonged recovery, and higher healthcare costs. Most studies combine all SSI categories, potentially overestimating economic burden due to higher severity of organ\/space infections. The specific cost impact of incisional SSIs\u2014superficial and deep infections\u2014remains underexplored, despite its prevention potential. This study aimed to evaluate hospital costs associated with incisional SSIs following colorectal resection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X25103218_as2\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective cohort study was conducted at a tertiary oncologic center, including patients who underwent surgical resection for primary neoplasms of the colon, rectum, or anal canal between 2018 and 2023. Patients with incisional SSIs were matched 1:1 to controls without SSI using propensity scores based on demographic and surgical variables. Total hospital costs within 60 days postoperatively were analyzed using real-world, institution-specific cost data. Multivariate regression was used to identify independent cost predictors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X25103218_as3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Among 985 eligible patients, 176 (17.9%) developed an incisional SSI. After matching, 346 patients (173 pairs) were included in the cost analysis. Mean hospital costs were significantly higher in the SSI group (\u20ac6,065.93 vs \u20ac5,089.97;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001), primarily due to prolonged hospitalization and increased outpatient care use (medical and nursing consultations). Incisional SSI was an independent predictor of higher costs, along with open surgery, comorbidities and stoma presence.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X25103218_as4\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Incisional SSIs associated with higher hospital costs after colorectal surgery. These findings support the implementation of targeted SSI prevention strategies to reduce complications and optimize healthcare resource use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/ice.2025.10321","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T09:39:49Z","timestamp":1760434789000},"page":"1199-1205","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":1,"title":["Assessment of hospital costs associated with incisional surgical site infection in patients undergoing colorectal surgery"],"prefix":"10.1017","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5934-6792","authenticated-orcid":false,"given":"Beatriz","family":"Costeira","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/047xxvg44","id-type":"ROR","asserted-by":"publisher"}],"name":"Instituto Portugu\u00eas de Oncologia de Lisboa Francisco Gentil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5302-4363","authenticated-orcid":false,"given":"Laura","family":"Silv\u00e9rio","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina da Universidade de Lisboa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1218-3920","authenticated-orcid":false,"given":"Rui","family":"Ara\u00fajo","sequence":"additional","affiliation":[{"name":"Instituto Portugu\u00eas de Oncologia de Lisboa Francisco Gentil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0356-8326","authenticated-orcid":false,"given":"Andr\u00e9","family":"Caiado","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/047xxvg44","id-type":"ROR","asserted-by":"publisher"}],"name":"Instituto Portugu\u00eas de Oncologia de Lisboa Francisco Gentil"},{"name":"Faculdade de Medicina da Universidade de Lisboa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6912-4978","authenticated-orcid":false,"given":"Daniela","family":"Cavadas","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/047xxvg44","id-type":"ROR","asserted-by":"publisher"}],"name":"Instituto Portugu\u00eas de Oncologia de Lisboa Francisco Gentil"},{"name":"Faculdade de Medicina da Universidade de Lisboa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2229-7143","authenticated-orcid":false,"given":"Tiago","family":"Cunha","sequence":"additional","affiliation":[{"name":"Instituto Portugu\u00eas de Oncologia de Lisboa Francisco Gentil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5904-6244","authenticated-orcid":false,"given":"Nuno","family":"Abecasis","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/047xxvg44","id-type":"ROR","asserted-by":"publisher"}],"name":"Instituto Portugu\u00eas de Oncologia de Lisboa Francisco Gentil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6509-6818","authenticated-orcid":false,"given":"Ros\u00e1rio","family":"Sep\u00falveda","sequence":"additional","affiliation":[{"name":"Instituto Portugu\u00eas de Oncologia de Lisboa Francisco Gentil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4645-1574","authenticated-orcid":false,"given":"Manuel","family":"Limbert","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/047xxvg44","id-type":"ROR","asserted-by":"publisher"}],"name":"Instituto Portugu\u00eas de Oncologia de Lisboa Francisco Gentil"},{"name":"Faculdade de Medicina da Universidade de Lisboa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2496-1642","authenticated-orcid":false,"given":"Jo\u00e3o","family":"Maciel","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/047xxvg44","id-type":"ROR","asserted-by":"publisher"}],"name":"Instituto Portugu\u00eas de Oncologia de Lisboa Francisco Gentil"},{"name":"Faculdade de Medicina da Universidade de Lisboa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2025,10,14]]},"reference":[{"key":"S0899823X25103218_ref4","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000124292.21605.99"},{"key":"S0899823X25103218_ref24","unstructured":"24. Committee on Economics. Statement on ASA Physical Status Classification System. https:\/\/www.asahq.org\/standards-and-practice-parameters\/statement-on-asa-physical-status-classification-system."},{"key":"S0899823X25103218_ref35","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2018.11.010"},{"key":"S0899823X25103218_ref3","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000219017.78611.49"},{"key":"S0899823X25103218_ref27","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2009.03.021"},{"key":"S0899823X25103218_ref30","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2013.09.012"},{"key":"S0899823X25103218_ref11","doi-asserted-by":"publisher","DOI":"10.1067\/msy.2003.212"},{"key":"S0899823X25103218_ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcadva.2024.100058"},{"key":"S0899823X25103218_ref12","doi-asserted-by":"publisher","DOI":"10.1086\/501572"},{"key":"S0899823X25103218_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2008.12.010"},{"key":"S0899823X25103218_ref6","doi-asserted-by":"publisher","DOI":"10.21037\/tcr-22-627"},{"key":"S0899823X25103218_ref14","unstructured":"14. CDC, Ncezid, DHQP. Surgical Site Infection Event (SSI). https:\/\/www.cdc.gov\/nhsn\/pdfs\/ps-analysis-resources\/ImportingProcedureData.pdf."},{"key":"S0899823X25103218_ref13","doi-asserted-by":"publisher","DOI":"10.1053\/jhin.2001.1003"},{"key":"S0899823X25103218_ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2005.04.246"},{"key":"S0899823X25103218_ref8","first-page":"1","article-title":"Global incidence of surgical site infection among patients: systematic review and meta-analysis","volume":"60","author":"Mengistu","year":"2023","journal-title":"Inquiry"},{"key":"S0899823X25103218_ref1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-200108000-00007"},{"key":"S0899823X25103218_ref26","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2017.03.004"},{"key":"S0899823X25103218_ref28","doi-asserted-by":"publisher","DOI":"10.1016\/j.cireng.2013.04.011"},{"key":"S0899823X25103218_ref34","volume-title":"Infection","year":"2018"},{"key":"S0899823X25103218_ref2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181638609"},{"key":"S0899823X25103218_ref5","doi-asserted-by":"publisher","DOI":"10.3390\/life14070850"},{"key":"S0899823X25103218_ref15","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2014.346"},{"key":"S0899823X25103218_ref33","doi-asserted-by":"publisher","DOI":"10.1177\/000313481908500219"},{"key":"S0899823X25103218_ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2022.01.023"},{"key":"S0899823X25103218_ref23","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"S0899823X25103218_ref18","unstructured":"18. European Centre for Disease Prevention and Control. Surveillance of surgical site infections and prevention indicators in European hospitals. HAI-Net SSI protocol, version 2.2. https:\/\/www.ecdc.europa.eu\/en\/publications-data\/surveillance-surgical-site-infections-and-prevention-indicators-european."},{"key":"S0899823X25103218_ref17","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2013.2925"},{"key":"S0899823X25103218_ref10","doi-asserted-by":"publisher","DOI":"10.1093\/ajhp\/55.8.777"},{"key":"S0899823X25103218_ref19","doi-asserted-by":"publisher","DOI":"10.1111\/codi.15875"},{"key":"S0899823X25103218_ref31","doi-asserted-by":"publisher","DOI":"10.1016\/j.hpb.2018.01.008"},{"key":"S0899823X25103218_ref25","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000133083.54934.ae"},{"key":"S0899823X25103218_ref16","doi-asserted-by":"publisher","DOI":"10.1007\/s00595-012-0126-8"},{"key":"S0899823X25103218_ref32","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2022.10.076"},{"key":"S0899823X25103218_ref21","doi-asserted-by":"publisher","DOI":"10.1007\/s40273-021-01112-8"},{"key":"S0899823X25103218_ref29","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002312"}],"container-title":["Infection Control &amp; Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0899823X25103218","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,29]],"date-time":"2026-03-29T07:46:45Z","timestamp":1774770405000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0899823X25103218\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,14]]},"references-count":35,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["S0899823X25103218"],"URL":"https:\/\/doi.org\/10.1017\/ice.2025.10321","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"value":"0899-823X","type":"print"},{"value":"1559-6834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,14]]},"assertion":[{"value":"\u00a9 The Author(s), 2025. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}