Risk Adjustment for Surgical Site Infection After Median Sternotomy in Children

2007 ◽  
Vol 28 (4) ◽  
pp. 398-405 ◽  
Author(s):  
Jessica Kagen ◽  
Warren B. Bilker ◽  
Ebbing Lautenbach ◽  
Louis M. Bell ◽  
Susan E. Coffin ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Pediatric Patients ◽  
Characteristic Curve ◽  
Risk Index ◽  
Tertiary Care ◽  
Median Sternotomy ◽  
Case Definition ◽  
Site Infection ◽  
Retrospective Case ◽  
Risk Indices

Objective.To determine whether the National Nosocomial Infections Surveillance (NNIS) System risk index adequately stratified a population of pediatric patients undergoing cardiac surgery according to the risk of developing surgical site infection (SSI).Design.A retrospective, case-control study.Setting.An urban tertiary care children's hospital.Patients.Patients who had a median sternotomy performed between January 1,1995, and December 31, 2003, were eligible for inclusion in the study. For all case patients, medical records were reviewed to verify that all patients met the case definition for SSI. Control subjects were chosen randomly from among all patients who underwent median sternotomy during the study period who did not develop SSI.Results.Thirty-eight patients with SSI and 172 patients without SSI were included. One hundred six patients (50%) were male. The median patient age was 4 months. The sensitivity of the NNIS risk index with cutoff scores of 0 to 1 and 2 to 3 was 20%. The distribution of patients with SSI for an NNIS risk index score of 0 was 0%; for a score of 1, 80%; for a score of 2, 20%; and for a score of 3, 0%. The distribution of patients without SSI for a scores of 0 was 4%; for a score of 1, 87%; for a score of 2, 9%; and for a score of 3, 0%. The area under the receiver-operating characteristic curve (AUC) of the original NNIS risk index was 0.57. The modified risk indices did not perform significantly better, with an AUC range of 0.58 to 0.73.Conclusions.The NNIS risk index did not adequately stratify pediatric patients undergoing median sternotomy according to their risk of developing an SSI. Various modifications to the risk index yielded only slightly higher AUC values.

scholarly journals A New Surgical Site Infection Risk Score: Infection Risk Index in Cardiac Surgery

2019 ◽  
Vol 8 (4) ◽  
pp. 480 ◽  
Author(s):  
Juan Bustamante-Munguira ◽  
Francisco Herrera-Gómez ◽  
Miguel Ruiz-Álvarez ◽  
Ana Hernández-Aceituno ◽  
Angels Figuerola-Tejerina
Keyword(s):  
Cardiac Surgery ◽  
Surgical Site Infection ◽  
Risk Score ◽  
Artery Bypass ◽  
Characteristic Curve ◽  
Risk Index ◽  
Bypass Graft ◽  
Test Sample ◽  
Infection Risk ◽  
Site Infection

Various scoring systems attempt to predict the risk of surgical site infection (SSI) after cardiac surgery, but their discrimination is limited. Our aim was to analyze all SSI risk factors in both coronary artery bypass graft (CABG) and valve replacement patients in order to create a new SSI risk score for such individuals. A priori prospective collected data on patients that underwent cardiac surgery (n = 2020) were analyzed following recommendations from the Reporting of studies Conducted using Observational Routinely collected health Data (RECORD) group. Study participants were divided into two periods: the training sample for defining the new tool (2010–2014, n = 1298), and the test sample for its validation (2015–2017, n = 722). In logistic regression, two preoperative variables were significantly associated with SSI (odds ratio (OR) and 95% confidence interval (CI)): diabetes, 3.3/2–5.7; and obesity, 4.5/2.2–9.3. The new score was constructed using a summation system for punctuation using integer numbers, that is, by assigning one point to the presence of either diabetes or obesity. The tool performed better in terms of assessing SSI risk in the test sample (area under the Receiver-Operating Characteristic curve (aROC) and 95% CI, 0.67/055–0.76) compared to the National Nosocomial Infections Surveillance (NNIS) risk index (0.61/0.50–0.71) and the Australian Clinical Risk Index (ACRI) (0.61/0.50–0.72). A new two-variable score to preoperative SSI risk stratification of cardiac surgery patients, named Infection Risk Index in Cardiac surgery (IRIC), which outperforms other classical scores, is now available to surgeons. Personalization of treatment for cardiac surgery patients is needed.

Risk Factors for Surgical Site Infection in Children

2006 ◽  
Vol 27 (7) ◽  
pp. 709-715 ◽  
Author(s):  
Juan Francisco Casanova ◽  
Rafael Herruzo ◽  
Jesús Díez
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Pediatric Patients ◽  
Risk Index ◽  
Venous Catheter ◽  
University Hospital ◽  
Site Infection ◽  
Convenience Sample ◽  
Peripheral Venous Catheter ◽  
Duration Of Surgery

Objectives.To assess the appropriateness of using the indices developed by the Study on the Efficacy of Nosocomial Infection Control (SENIC) and the National Nosocomial Infections Surveillance (NNIS) project to determine risk factors for surgical site infection (SSI) in children and, if not appropriate, to explore the factors related to SSI in children so these factors could be used in a risk index for pediatric patients.Design.Cohort study during more than 4 years.Setting.La Paz University Hospital, a national reference center that serves Health Area 5 of Madrid, Spain, which has approximately 500,000 inhabitants.Patients.Convenience sample consisting of the 3,646 children admitted for surgery who had a postsurgical stay of more than 2 days.Results.A model with 8 predictive factors (degree of surgical contamination; duration of surgery; type of surgery; use of a peripheral venous catheter, central venous catheter, or urinary catheter; number of diagnoses; and SSI exposition time) was created. Its relation to the SSI rate was better than that of the SENIC or NNIS indices. Its sensitivity, specificity, and area under the receiver–operating characteristic curve were higher than that of the SENIC index.Conclusions.The model that we created seems to be more adequate for predicting SSI and evaluating pediatric patients' intrinsic risk than the SENIC and NNIS indices.

Risk Factors for Surgical Site Infection Complicating Laminectomy

2007 ◽  
Vol 28 (9) ◽  
pp. 1060-1065 ◽  
Author(s):  
N. Deborah Friedman ◽  
Daniel J. Sexton ◽  
Sarah M. Connelly ◽  
Keith S. Kaye
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Risk Index ◽  
Tertiary Care ◽  
Operating Experience ◽  
Care Facility ◽  
Site Infection ◽  
Surgical Specialty ◽  
Tertiary Care Facility ◽  
Independent Risk Factors

Objective.To examine risk factors for surgical site infection (SSI) following spinal surgery and to analyze the associations between a surgeon's years of operating experience and surgical specialty and patients' SSI risk.Design.Case-control study.Setting.A tertiary care facility and a community hospital in Durham, North Carolina.Patients.Each case patient who developed an SSI complicating laminectomy was matched with 2 noninfected control patients by hospital, year of surgery, and National Nosocomial Infection Surveillance System risk index score.Results.Forty-one case patients with SSI complicating laminectomy and 82 matched control patients were analyzed. Nonwhite race, diabetes and an elevated body mass index (BMI) were more common among case patients than among control patients. Subjects with a BMI greater than 35 were more likely to undergo a prolonged procedure, compared with case patients who had a BMI of 35 or less. The SSI rate for patients operated on by neurosurgeons was 28%, compared with 43% for patients operated on by orthopedic surgeons (odds ratio [OR], 0.5; P = .12). The number of years of operating experience were not associated with SSI risk. Multivariate analysis revealed diabetes (OR, 4.2 [95% confidence interval {CI}, 1.1-16.3]; P = .04), BMI greater than 35 (OR, 7.1 [95% CI, 1.8-28.3]; P = .005), and laminectomy at a level other than cervical (OR, 6.7 [95% CI, 1.4-33.3]; P = .02) as independent risk factors for SSI following laminectomy.Conclusion.Diabetes, obesity, and laminectomy at a level other than cervical are independent risk factors for SSI following laminectomy. Preoperative weight loss and tight perioperative control of blood glucose levels may reduce the risk of SSI in laminectomy patients.

scholarly journals Surgical Site Infection after Renal Transplantation

2015 ◽  
Vol 36 (4) ◽  
pp. 417-423 ◽  
Author(s):  
Anthony D. Harris ◽  
Brandon Fleming ◽  
Jonathan S. Bromberg ◽  
Peter Rock ◽  
Grace Nkonge ◽  
...  
Keyword(s):  
Renal Transplantation ◽  
Surgical Site Infection ◽  
Vascular Disease ◽  
Risk Index ◽  
Tertiary Care ◽  
Adult Patients ◽  
Site Infection ◽  
Peripheral Vascular ◽  
Rheumatologic Disease ◽  
History Of

OBJECTIVETo identify factors associated with the development of surgical site infection (SSI) among adult patients undergoing renal transplantationDESIGNA retrospective cohort studySETTINGAn urban tertiary care center in Baltimore, Maryland, with a well-established renal transplantation program that performs ~200–250renal transplant procedures annuallyRESULTSAt total of 441 adult patients underwent renal transplantation between January 1, 2010, and December 31, 2011. Of these 441patients, 66 (15%) developed an SSI; of these 66, 31 (47%) were superficial incisional infections and 35 (53%) were deep-incisional or organ-space infections. The average body mass index (BMI) among this patient cohort was 29.7; 84 (42%) were obese (BMI >30). Patients who developed an SSI had a greater mean BMI (31.7 vs 29.4; P=.004) and were more likely to have a history of peripheral vascular disease, rheumatologic disease, and narcotic abuse. History of cerebral vascular disease was protective. Multivariate analysis showed BMI (odds ratio [OR] 1.06; 95% confidence interval [CI], 1.02–1.11) and past history of narcotic use/abuse (OR, 4.86; 95% CI, 1.24–19.12) to be significantly associated with development of SSI after controlling for National Healthcare Surveillance Network (NHSN) score and presence of cerebrovascular, peripheral vascular, and rheumatologic disease.CONCLUSIONSWe identified higher BMI as a risk factor for the development of SSI following renal transplantation. Notably, neither aggregate comorbidity scores nor NHSN risk index were associated with SSI in this population. Additional risk adjustment measures and research in this area are needed to compare SSIs across transplant centers.Infect Control Hosp Epidemiol 2015;00(0): 1–7

Surgical Site Infections - A Hospital Havoc: Retrospective Study of Surgical Site Infections in Tertiary Health Care Centre in North East India

2018 ◽  
Vol 3 (01) ◽  
Author(s):  
V Singh ◽  
A B Khyriem, W V Lyngdoh ◽  
C J Lyngdoh
Keyword(s):  
Surgical Site Infection ◽  
Multiple Drug Resistance ◽  
Surgical Site Infections ◽  
Multidrug Resistant ◽  
Multiple Drug ◽  
Site Infection ◽  
Retrospective Case ◽  
Acinetobacter Baumanii ◽  
Health Care Centre ◽  
North East

Objectives - Surgical site infections (SSI) has turn out to be a major problem even in hospital with most modern facilities and standard protocols of pre -operative preparation and antibiotic prophylaxis. Objective of this study is to know the prevalence of surgical site infection among the postoperative patients and to identify the relationship between SSI and etiological pathogens along with their antimicrobial susceptibility at North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong. Methods - A retrospective case study conducted at NEIGRIHMS, among patients admitted to the surgical departments during the period between January 1st and December 31st 2016. Swabs from the surgical sites were collected under sterile conditions and standard bacteriological tests were performed for identification and appropriate statistical methods were employed to look for association between SSI and etiological pathogens. Results - Out of the 1284 samples included in the study, 192 samples showed evidence of SSI yielding an infection rate of 14.9%. The most commonly isolated bacteria were: Escherichia coli, Acinetobacter baumanii and Staphylococcus aureus, of the gram negative isolates 6.2% were multidrug resistant of which 19% were carbapenem resistant. Conclusion - SSI with multiple drug resistance strains and polymicrobial etiology reflects therapeutic failure. The outcome of the SSI surveillance in our hospital revealed that in order to decrease the incidence of SSI we would have to: a) incorporate a proper antibiotic stewardship  b) conduct periodic surveillance to keep a check on SSI d) educate medical staffs regarding the prevention of surgical site infection.

Risk Factors Associated with Surgical Site Infection in Pediatric Patients Undergoing Spinal Deformity Surgery

JBJS Reviews ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. e0163
Author(s):  
Hiroko Matsumoto ◽  
Matthew E. Simhon ◽  
Megan L. Campbell ◽  
Michael G. Vitale ◽  
Elaine L. Larson
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Spinal Deformity ◽  
Pediatric Patients ◽  
Site Infection ◽  
Factors Associated ◽  
Spinal Deformity Surgery

Surgical site infection in colorectal surgeries: Experience in tertiary care hospital

2015 ◽  
Vol 12 ◽  
pp. S11
Author(s):  
Afshan Anjum Wani ◽  
Nisar Ahmad Chowdri ◽  
Fazal Q. Parray ◽  
Rouf A. Wani
Keyword(s):  
Surgical Site Infection ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Site Infection

scholarly journals Independent risk factors for surgical site infection after cesarean delivery in a rural tertiary care medical center

2016 ◽  
Vol 31 (1) ◽  
pp. 120-126 ◽  
Author(s):  
Manuel C. Vallejo ◽  
Ahmed F. Attaallah ◽  
Robert E. Shapiro ◽  
Osama M. Elzamzamy ◽  
Michael G. Mueller ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Cesarean Delivery ◽  
Medical Center ◽  
Tertiary Care ◽  
Site Infection ◽  
Tertiary Care Medical Center ◽  
Independent Risk Factors
Sign in / Sign up

Export Citation Format

Share Document