PMID- 31933608
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220412
IS  - 1682-024X (Print)
IS  - 1681-715X (Electronic)
IS  - 1681-715X (Linking)
VI  - 36
IP  - 1
DP  - 2020 Jan
TI  - Self-Diagnosis of Surgical Site Infections: Lessons from a tertiary care centre 
      in Karachi, Pakistan.
PG  - S55-S60
LID - 10.12669/pjms.36.ICON-Suppl.1716 [doi]
AB  - BACKGROUND AND 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: 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: 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: 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.
CI  - Copyright: (c) Pakistan Journal of Medical Sciences.
FAU - Sajun, Sana Z
AU  - Sajun SZ
AD  - Sana Z Sajun, MSc. Interactive Research and Development, Karachi, Pakistan.
FAU - Albutt, Katherine
AU  - Albutt K
AD  - Katherine Albutt, MD MPH. Department of Surgery, Massachusetts General Hospital, 
      Program in Global Surgery and Social Change, Harvard Medical School, Boston, USA.
FAU - Moosajee, Umme Salama
AU  - Moosajee US
AD  - Umme Salama Moosajee, BSc. Center for Essential Surgery and Acute Care, Global 
      Health Directorate, Indus Health Network, Karachi, Pakistan.
FAU - Drevin, Gustaf
AU  - Drevin G
AD  - Gustaf Drevin, Program in Global Surgery and Social Change, Harvard Medical 
      School, Boston, USA.
FAU - Mukhopadhyay, Swagoto
AU  - Mukhopadhyay S
AD  - Swagoto Mukhopadhyay, MD. Program in Global Surgery and Social Change, Harvard 
      University, Department of Surgery, Boston, USA.
FAU - Samad, Lubna
AU  - Samad L
AD  - Lubna Samad, MRCS FCPS. Center for Essential Surgery and Acute Care, Global 
      Health Directorate, Indus Health Network, Karachi, Pakistan.
LA  - eng
PT  - Journal Article
PL  - Pakistan
TA  - Pak J Med Sci
JT  - Pakistan journal of medical sciences
JID - 100913117
PMC - PMC6943118
OTO - NOTNLM
OT  - Low-and Middle-Income Countries
OT  - Pakistan
OT  - Patient Self-screening
OT  - Surgical Site Infection
COIS- Conflict Interests: None.
EDAT- 2020/01/15 06:00
MHDA- 2020/01/15 06:01
PMCR- 2020/01/01
CRDT- 2020/01/15 06:00
PHST- 2020/01/15 06:00 [entrez]
PHST- 2020/01/15 06:00 [pubmed]
PHST- 2020/01/15 06:01 [medline]
PHST- 2020/01/01 00:00 [pmc-release]
AID - PJMS-36-S55 [pii]
AID - 10.12669/pjms.36.ICON-Suppl.1716 [doi]
PST - ppublish
SO  - Pak J Med Sci. 2020 Jan;36(1):S55-S60. doi: 10.12669/pjms.36.ICON-Suppl.1716.