Developing a Surgical Site Infection Surveillance System Based on Hospital Unstructured Clinical Notes and Text Mining

2020 ◽  
Vol 21 (8) ◽  
pp. 716-721 ◽  
Author(s):  
Marta Luisa Ciofi Degli Atti ◽  
Fabrizio Pecoraro ◽  
Simone Piga ◽  
Daniela Luzi ◽  
Massimiliano Raponi
2007 ◽  
Vol 28 (1) ◽  
pp. 36-41 ◽  
Author(s):  
J. Manniën ◽  
A. E. van der Zeeuw ◽  
J. C. Wille ◽  
S. van den Hof

Objectives.To describe how continuous validation of data on surgical site infection (SSI) is being performed in the Dutch National Nosocomial Infection Surveillance System (Preventie Ziekenhuisinfecties door Surveillance [PREZIES]), to assess the quality and accuracy of the PREZIES data, and to present the corresponding outcomes of the assessment.Design.Mandatory, 1-day on-site validation visit to participating hospitals every 3 years. The process of surveillance, including the quality of the method of data collection, is validated by means of a structured interview. The use of SSI criteria is validated by review of medical records, with the judgment of the validation team as the criterion standard.Setting.Hospitals participating in PREZIES.Results.During 1999-2004, the validation team visited 40 hospitals and reviewed 859 medical charts. There was no deviation between reports of SSI by infection control professionals and findings by the PREZIES validation team at 30 hospitals and 1 deviation in each of 10 hospitals; the positive predictive value was 0.97, and the negative predictive value was 0.99. The validation team often gave advice to the hospital, aimed at perfecting the process of surveillance. On 2 occasions, data were removed from the PREZIES database after the validation visit revealed deviations from the SSI surveillance protocol that could have resulted in nonrepresentative SSI rate data.Conclusions.PREZIES is confident that the assembled Dutch SSI surveillance data are reliable and robust and are sufficiently accurate to be used as a reference for interhospital comparison. PREZIES will continue performing on-site validation visits, to improve the process of surveillance and ensure the reliability of the surveillance data.


Author(s):  
Kyoung Ho Rho ◽  
Hye Ran Jeong ◽  
Su Hyun Kim ◽  
Hee Jung Choi ◽  
Sun Ju Jung ◽  
...  

2008 ◽  
Vol 31 (4) ◽  
pp. 21 ◽  
Author(s):  
G W Rose ◽  
V R Roth ◽  
K N Suh ◽  
M Taljaard ◽  
C Van Walraven ◽  
...  

Background/Purpose: Surgical site infection surveillance to determineincidence is a key infection control activity. Case detection is labour-intensive, therefore most infection control programs use manual or simple electronic mechanisms to “trigger” chart review. However, such “trigger” mechanisms are also labour-intensive, and often of poor specificity. Our objective is to develop a complex trigger mechanism using data from an electronic data warehouse, to improve specificity of surveillance of surgical site infection compared to current trigger mechanisms. Methods: We will derive an electronic trigger tool for cardiac surgical site infection surveillance using a nested case-control design, among a cohort of all patients undergoing coronary artery bypass grafting, cardiac valve repairor replacement, or heart transplant at the University of Ottawa Heart Institute, from July 1 2004 to June 30 2007. We will perform a systematic literature review to identify potential trigger factors to include in the model, then construct the trigger tool by backwards stepwise logistic regression. The best-fit model will be used to calculate the probability of surgical site infection. We will select the threshold probability to use in surveillance by visual inspection of receiver-operator-characteristic curves. The accuracy of this electronic trigger mechanism will be compared to pre-existing manual and simple electronic mechanisms using relative true positive ratios and relative false positive ratios. Results/Conclusions: We have selected 200 cases of surgical site infection and 541 controls from among 3744 procedures performed during the study period. As of the date ofthis abstract we are still undertaking the systematic review.


2020 ◽  
Vol 41 (S1) ◽  
pp. s157-s157
Author(s):  
Kelly Baekyung Choi ◽  
John Conly ◽  
Blanda Chow ◽  
Joanne Embree ◽  
Bonita Lee ◽  
...  

Background: Surgical site infection (SSI) after cerebrospinal fluids (CSF) shunt surgery is thought to be acquired intraoperatively. Biomaterial-associated infection can present up to 1 year after surgery, but many national systems have shortened follow-up to 90 days. We compared 3- versus 12-month follow-up periods to determine the nature of case ascertainment in the 2 periods. Methods: Participants of any age with placement of an internal CSF shunt or revision surgical manipulation of an existing internal shunt identified in the Canadian Nosocomial Infection Surveillance Program (CNISP) participating hospitals between 2006 and 2018 were eligible. We excluded patients with external shunting devices or culture-positive CSF at the time of surgery. Patients were followed for 12 months after surgery for the primary outcome of a CSF infection with a positive CSF culture by review of laboratory and health records. Patients were categorized as adult (aged ≥18 years) or pediatric (aged < 18 years). The infection rate was expressed as the number of CSF shunt-associated infections divided by the number of shunt surgeries per 100 procedures. Results: In total, 325 patients (53% female) met inclusion criteria in 14 hospitals from 7 provinces were identified. Overall, 46.1% of surgeries were shunt revisions and 90.3% of shunts were ventriculoperitoneal. For pediatric patients, the median age was 0.7 years (IQR, 0.2–7.0). For adult patients, the median age was 47.9 years (IQR, 29.6–64.6). The SSI rates per 100 procedures were 3.69 for adults and 3.65 for pediatrics. The overall SSI rates per 100 procedures at 3 and 12 months were 2.74 (n = 265) and 3.48 (n = 323), respectively. By 3 months (90 days), 82% of infection cases were identified (Fig. 1). The median time from procedure to SSI detection was 30 days (IQR, 10–65). No difference was found in the microbiology of the shunt infections at 3- and 12-month follow-ups. The most common pathogens were coagulase-negative Staphylococcus (43.6 %), followed by S. aureus (24.8 %) and Propionibacterium spp (6.5 %). No differences in age distribution, gender, surgery type (new or revision), shunt type, or infecting organisms were observed when 3- and 12-month periods were compared. Conclusions: CSF-SSI surveillance for 3 versus 12 months would capture 82.0% (95% CI, 77.5–86.0) of cases, with no significant differences in the patient characteristics, surgery types, or pathogens. A 3-month follow-up can reduce resources and allow for more timely reporting of infection rates.Funding: NoneDisclosures: None


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