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The number of surgical site infections after hysterectomies at Intermountain Medical Center in 2015 was more than double what was predicted.
Of the 306 hysterectomies performed at Intermountain last year, 12 resulted in surgical site infections. The Centers for Disease Control and Prevention estimated that there would have been 5.79.
Licensed Utah hospitals are required to report various health-care-associated infections — developed when patients are being treated for another condition — to the National Healthcare Safety Network. The number of infections reported is compared to the CDC prediction for each facility, which is based on its size, volume of procedures and complexity of the conditions treated, said Karen Singson, the state Department of Health's health-care-associated infections program manager. The state then annually compiles that data in a public report, released Thursday.
Kristin Dascomb, an Intermountain physician specializing in infectious diseases, said the hysterectomy numbers are "obviously a concern," but that the system has been working diligently to "reduce or eliminate the risk of infection to patients."
For example, Dascomb said, officials are making sure pre-operative medication is administered on time and appropriately. Intermountain receives more severe cases than some hospitals, she said, which also contributes to the higher number.
Overall, Utah hospitals reported more surgical site infections within 30 days of both hysterectomies and colon surgeries than estimated. But compared to estimates, they had significantly fewer MRSA bacteria infections and central-line-associated bloodstream infections.
The department "continues to work with facilities to ensure accurate reporting and focus on prevention strategies to reduce the potential for [health-care-associated infections]," Singson said.
The report also showed Intermountain had fewer than expected central-line-associated bloodstream infections in 2015. Intermountain reported 9,205 total days that a patient had a central line in adult and pediatric intensive care units in 2015, with 10 infections. The CDC estimated it would have 16.53.
However, its catheter-associated urinary tract infections were higher than estimated. For example, Intermountain had 10,864 total days that a patient had a urinary catheter in adult and pediatric intensive care units in 2015, and there were 44 infections, the report states. The CDC estimated there would be 25.64 infections.
Dascomb said the high numbers are partly due to the system's efforts to reduce the number of days patients use catheters.
The number of catheter-associated urinary tract infections in inpatient rehabilitation at University Hospital also are higher than estimated for the same reason, said Jeanmarie Mayer, the hospital epidemiologist.
The hospital also had higher than expected surgical site infections after hysterectomies, which Mayer said is partly because the CDC does not take some risk adjustments into account, such as cancer.
"We have a higher proportion of women with widespread cancer, so those women would be at higher risk [for infection] as well," Mayer said. "These are less of routine elective procedures and more [emergency] hysterectomies."
But they had fewer central-line-associated bloodstream infections in intensive care, according to the report.
These numbers "are one piece of health care," Mayer said. "When you look at infections overall, we are doing well."
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