Surgical wound infection rate (%), all operations

Albania

Ministry of Health.

Armenia

Source of data: National Health Information Analytic Center, Ministry of Health of the Republic of
Armenia http://moh.am/?section=static_pages/index&id=625&subID=824,29.
Data collected annually, reference period: 31 December.

Austria

Data are not available.

Belgium

Source: Federal Public Service of Public Health, Food Chain Safety and Environment. Health Care
Facilities Organization (DG1).

Cyprus

No data are available

Czechia

Source: Institute of Health Information and Statistics of CR (IHIS CR). National Registry of
Hospitalized Patients.
Coverage: Surgical wound complications of all operations in hospitals. Surgical wound infection rate
is long-term underreported by providers and does not comply with expert estimates and studies.
Break in time series: Until 1992 only surgical departments included. Since 1993 all departments in
general hospitals included.

Estonia

Not available.

Finland

Source: Hospital Discharge Register, THL (National Institute for Health and Welfare).

France

Data are not available.

Germany

Source: Federal Statistical Office, Hospital statistics - diagnostic data of the hospital patients,
special evaluation by the Federal Statistical Office.
Coverage: Data refers to the proportion of patients with an infection following a procedure, n.e.c.
(ICD-10: T81.4) that have undergone an operation prior to their release from hospital in % of all
patients who were operated before discharging from hospital. The number of discharges includes
deaths in hospitals, but excludes same-day separations and transfers to other care units within the
same institutions.
From the reporting year 2000, for the first time, data have been collected according to ICD-10.
Comparable data before reporting year 2000 is not available.

Greece

Data are not available.

Hungary

Source until 2003: Center for Health Care Information (GYOGYINFOK). Source from 2004: National
Institute for Strategic Health Research (ESKI). Source from 2012: National Institute for Quality-
and Organizational Development in Healthcare and Medicines (GYEMSZI). Source from 2015: Directorate
for Organizing and Developing Healthcare Service (µEEK).
More than one surgery are performed at the same time not more proportionally increase the risk for
wound infection so we consider one patient?s multiple procedures at the same time and in the same
operating room as one surgical event. Calculate surgical wound infection rate: there is T81.4
ICD10 code in the record or there is ?nosocomial infection? field value is ?yes? for surgery.

Iceland

Data are not available.

Ireland

Source: The data presented are derived from the HIPE (Hospital In-Patient Enquiry) data set, which
records data on discharges from all publicly funded acute hospitals. The Healthcare Pricinf Office
(HPO) manages the HIPE system. See www.hpo.ie.

Coverage:
HIPE data covers all in-patients and day cases receiving curative and rehabilitative care in
publicly funded acute hospitals in the State.
For historical reasons, a small number of non-acute hospitals are included in the NHDDB. This
activity represents less than 0.5% of total activity in the NHDDB.
HIPE data do not include private hospitals. Activity data for private hospitals is not available,
however based on a household survey carried out by the Central Statistics Office in 2010 it is
estimated that approximately 15% of all hospital inpatient activity in Ireland is undertaken in
private hospitals. It should be emphasized that this is an estimate only and so should be
interpreted with caution.
The data coverage in HIPE exceeds 96%, i.e. overall approximately 4% of activity in publicly funded
acute general hospitals is missing from HIPE.
The definition of day case is a patient who is formally admitted with the intention of discharging
the patient on the same day, and where the patient is in fact discharged as scheduled (i.e.
excluding deaths and emergency transfers) on the same day. All other patients, including those who
are admitted or discharged as emergencies on the same day, are considered in-patients. In accordance
with WHO guidelines, day cases have been excluded from the data presented for discharges. This
definition is the same as that used in submission of data to the OECD and Eurostat. This ensures
consistency in HIPE data reported by international organisations.

Deviation from the definition:
Data refer to the number of inpatient discharges with a surgical diagnosis related group (DRG) and
with a secondary diagnosis of post-operative infection (ICD9-CM 998.5 for 1994-2004 and ICD-10-AM
T81.41 for 2005 onwards) during the same hospital episode, divided by total number of in-patient
discharges with a surgical DRG. DRG designation is primarily based on the main diagnosis and main
procedure (and other factors such as age).
Prior to 2005, HIPE data was coded in ICD-9-CM. The ICD-9-CM classification categorized every
procedure as an OR procedure or non-OR procedure. From 2005, HIPE data is coded using ICD-10-AM (the
Australian Modification of ICD-10 incorporating the Australian Classification of Health
Interventions). However in ICD-10-AM there is no comprehensive list of OR or non-OR procedures. For
this reason, the surgical DRG methodology is used for all years.
Note that the ICD-10-AM classification provides a further breakdown of ICD-10 T81.4. The ICD-10-AM
diagnosis code T81.41 refers to ?Wound infection following a procedure?, and does not include
?Sepsis following a procedure? which is coded as ICD-10-AM T81.42.
Break in time series:
Data for 1994-2004 were classified using ICD-9-CM. All HIPE discharges from 2005 are now coded using
ICD-10-AM (the Australian Modification of ICD-10 incorporating the Australian Classification of
Health Interventions). The change from ICD-9-CM to ICD-10-AM has resulted in some minor changes in
the classification of diagnoses and procedures, and a change from HCFA DRGs to Australian Refined
DRGs (ARDRGs). For more information on the introduction of ICD-10-AM in Ireland see
http://www.esri.ie/health_information/hipe/clinical_coding/classifications/.

Latvia

Data are not available.

Lithuania

Data are not available.

Luxembourg

Data are not available.

Malta

Data are not available.

Montenegro

Data are not available.

Netherlands

Data are not available.

Norway

Source of data: Data are available from 2006 ? and are collected from the national register
(Norwegian Surveillance System for Infections and Antibiotic Consumption in Health Institutions
(NOIS)), that was founded in 2005.

Coverage: The definition used for Norway is the sum of in hospital infection rate for the following
four operations: Caesarean section, coronary bypass, cholecystectomy, arthroplasty of hip. These
operations constitute about 10% per cent of all hospital based surgeries in Norway. The ECDC
definitions for surgical site infections are used.

Poland

Data are not available.

Portugal

Ministry of Health ? Central Administration of Health System (ACSS). Coverage: Only the acute
hospitals that belong to the National Health Service (NHS) on the mainland are included. The data
from the hospitals located in the autonomous regions of Azores and Madeira, and the private
hospitals are not included.

Serbia

No data are available.

Slovakia

Data are not available.

Slovenia

Source of data: National Institute of Public Health, Slovenia (NIJZ)
Difference in methodology: From 2013 there are some changes in the methodology of collecting data.

Sweden

Source of data: National Board of Health and Welfare (NBHW)
National Patient Register (NBHW)
ICD-9: 520-579

We have not been able to reconstruct how the old data were produced, but have replaced them with the
following.
Inpatient surgical operations is operationalised as all care episodes that include surgery ? an
episode is counted as one instance of surgery even if several surgical operations are listed. This
number constitutes the denominator. The classification used is KKA97 (Classification of surgery)
http://www.socialstyrelsen.se/publikationer2004/2004-4-1
Postoperative surgical wound infection wound corresponds to the diagnosis code T84.1 as primary or
complementary diagnosis. We have no data if the patient was treated only in primary care, since the
register covers only hospital care. As from 2005, day surgery in the hospital can be included.
Earlier data can only cover surgery in overnight care. Since there is a need to report a long time
series, the data included only counts the latter. Hence, the data are probably grossly
underestimated compared to the real numbers. This number constitutes the nominator.
Because of a discovered dis-calculation some indicator values has slightly changed since last year
which affects previous time series from the year 2005 and ahead.

Türkiye

No data are available.

Ukraine

Data are not available.

United Kingdom

Source of Data: England - Health and Social Care Information Centre. Data for 2013 is currently
unavailable so data from 2012 has been re-used to provide an approximate figure for 2013.
Wales - NHS Wales Informatics Service (NWIS), Figures based on Welsh Providers. Financial year.
Total procedures and surgical wounds infection rates figures were re-run in December 2014 based on
the ?episode of discharge? counts (discharges). Before the numbers were based on the count of
operations inflating figures. Only discharges with valid operation codes are counted. (This was done
in line with how England report these data).

Scotland ? Information Services Division Scotland, figures based on SMR01 data.
Coverage: Data includes Great Britain only. Data relate to NHS activity or NHS commissioned activity
in the independent sector. Figures are based on financial episode end year.
Estimation Method: This is a proxy measure. There is no agreed list of OPCS procedure codes from
which the UK can accurately identify surgical procedures. As such the rate is calculated as a
proportion of total inpatient procedures.

All operations from 2011-12 to 2012-13 are defined as having an OPCS 4.6 procedure code between A00
and X97, excluding O11, O12, O13, O14, O16, O28 and O30. All operations prior to 2011-12 are defined
as having an OPCS 4 procedure code between A00-O10 and O15-X97.


Break in Time Series: Data from 2000 onwards is not comparable with data from prior to this. This is
due to work conducted to improve compliance with definitions and consistency of methodologies across
the four parts of the UK.