Self-Diagnosis of Surgical Site Infections: Lessons from a tertiary care centre in Karachi, Pakistan.
Low-and Middle-Income Countries
Pakistan
Patient Self-screening
Surgical Site Infection
Journal
Pakistan journal of medical sciences
ISSN: 1682-024X
Titre abrégé: Pak J Med Sci
Pays: Pakistan
ID NLM: 100913117
Informations de publication
Date de publication:
Jan 2020
Jan 2020
Historique:
entrez:
15
1
2020
pubmed:
15
1
2020
medline:
15
1
2020
Statut:
ppublish
Résumé
Surgical site infections (SSIs) usually manifest post-discharge, rendering accurate diagnosis and treatment challenging, thereby catalyzing the development of alternate strategies like self-monitored SSI surveillance. This study aimed to evaluate the diagnostic accuracy of patients and Infection Control Monitors (ICMs) to develop a replicable method of SSI-detection. A two-year prospective diagnostic accuracy study was conducted in Karachi, Pakistan between 2015 and 2017. Patients were educated about SSIs and provided with questionnaires to elicit symptoms of SSI during post-discharge self-screening. Results of patient's self-screening and ICM evaluation at follow-ups were compared to surgeon evaluation. A total of 348 patients completed the study, among whom 18 (5.5%) developed a SSI. Patient self-screening had a sensitivity of 39%, specificity of 95%, positive predictive value (PPV) of 28%, and negative predictive value (NPV) of 97%. ICM evaluation had a sensitivity of 82%, specificity of 99%, PPV of 82%, and NPV of 99%. Patients cannot self-diagnose a SSI reliably. However, diagnostic accuracy of ICMs is significantly higher and they may serve as a proxy for surgeons, thereby reducing the burden on specialized surgical workforce in LMICs. Regardless, supplementing post-discharge follow-up with patient self-screening could increase SSI-detection and reduce burden on health systems.
Sections du résumé
BACKGROUND AND OBJECTIVE
OBJECTIVE
Surgical site infections (SSIs) usually manifest post-discharge, rendering accurate diagnosis and treatment challenging, thereby catalyzing the development of alternate strategies like self-monitored SSI surveillance. This study aimed to evaluate the diagnostic accuracy of patients and Infection Control Monitors (ICMs) to develop a replicable method of SSI-detection.
METHODS
METHODS
A two-year prospective diagnostic accuracy study was conducted in Karachi, Pakistan between 2015 and 2017. Patients were educated about SSIs and provided with questionnaires to elicit symptoms of SSI during post-discharge self-screening. Results of patient's self-screening and ICM evaluation at follow-ups were compared to surgeon evaluation.
RESULTS
RESULTS
A total of 348 patients completed the study, among whom 18 (5.5%) developed a SSI. Patient self-screening had a sensitivity of 39%, specificity of 95%, positive predictive value (PPV) of 28%, and negative predictive value (NPV) of 97%. ICM evaluation had a sensitivity of 82%, specificity of 99%, PPV of 82%, and NPV of 99%.
CONCLUSION
CONCLUSIONS
Patients cannot self-diagnose a SSI reliably. However, diagnostic accuracy of ICMs is significantly higher and they may serve as a proxy for surgeons, thereby reducing the burden on specialized surgical workforce in LMICs. Regardless, supplementing post-discharge follow-up with patient self-screening could increase SSI-detection and reduce burden on health systems.
Identifiants
pubmed: 31933608
doi: 10.12669/pjms.36.ICON-Suppl.1716
pii: PJMS-36-S55
pmc: PMC6943118
doi:
Types de publication
Journal Article
Langues
eng
Pagination
S55-S60Informations de copyright
Copyright: © Pakistan Journal of Medical Sciences.
Déclaration de conflit d'intérêts
Conflict Interests: None.
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