Surgical Site Infections in a "High Outlier" Institution
- 1 March 2009
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Diseases of the Colon & Rectum
- Vol. 52 (3), 374-379
- https://doi.org/10.1007/dcr.0b013e31819a5e45
Abstract
In 2006, the Cleveland Clinic was a "high outlier" for surgical site infections in the National Surgical Quality Improvement Program. Because this finding may be due to a high proportion of colorectal procedures at the Cleveland Clinic, the purpose of the present study was to compare the national and Cleveland Clinic databases regarding proportion of colorectal procedures and to investigate the frequency of SSI after colorectal versus general and vascular surgery and the factors that predict risk of SSI. Logistic regression analysis was used to analyze patient and procedure factors in cases with and those without surgical site infections from the Cleveland Clinic's National Surgical Quality Improvement Program database. Compared with the national database, the Clinic database had a significantly higher proportion of patients who had undergone colorectal procedures: 9.4 percent (11,102/118,391) vs. 17.0 percent (280/1,646) (P 30, platelet count 55. Procedure-related risk was operation duration >180 min (all P CONCLUSION: Participation in the National Surgical Quality Improvement Program brought attention to our high rate of SSI, which appeared to be due to a high proportion of colorectal patients, a high-risk subset. Further analysis identified unique SSI risk factors in this subgroup; most are not amenable to modification. Colorectal surgery may require unique risk adjustment for SSIs because of the nature of the operations and inherent risk of SSIs.Keywords
This publication has 12 references indexed in Scilit:
- Laparoscope Use and Surgical Site Infections in Digestive SurgeryAnnals of Surgery, 2008
- Surgical site infections after colorectal surgery: Do risk factors vary depending on the type of infection considered?Surgery, 2007
- No Pay for No PerformanceSurgical Infections, 2007
- Multivariable Predictors of Postoperative Surgical Site Infection after General and Vascular Surgery: Results from the Patient Safety in Surgery StudyJournal of the American College of Surgeons, 2007
- Elective Colon and Rectal Surgery Differ in Risk Factors for Wound InfectionAnnals of Surgery, 2006
- Hospitals collaborate to decrease surgical site infectionsThe American Journal of Surgery, 2005
- National Nosocomial Infections Surveillance (NNIS) System Report, data summary from January 1992 through June 2004, issued October 2004American Journal of Infection Control, 2004
- Hospital costs associated with surgical complications: A report from the private-sector National Surgical Quality Improvement ProgramJournal of the American College of Surgeons, 2004
- The Department of Veterans Affairs' NSQIPAnnals of Surgery, 1998
- CDC definitions of nosocomial surgical site infections, 1992: A modification of CDC definitions of surgical wound infectionsAmerican Journal of Infection Control, 1992