TY - JOUR
T1 - Procedure-specific surgical site infection incidence varies widely within certain National Healthcare Safety Network surgery groups
AU - Saeed, Mohammed J.
AU - Dubberke, Erik R.
AU - Fraser, Victoria J.
AU - Olsen, Margaret A.
N1 - Funding Information:
The Center for Administrative Data Research is supported in part by the Washington University Institute of Clinical and Translational Sciences grant UL1 TR000448 from the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health (NIH) , Grant Number R24 HS19455 through the Agency for Healthcare Research and Quality (AHRQ) , and Grant Number KM1CA156708 through the National Cancer Institute (NCI) at the National Institutes of Health (NIH).
Funding Information:
Funding/Support: Drs Dubberke, Fraser, and Olsen were supported in part by the Centers for Disease Control and Prevention Epicenters Program (grant no. U54CK000162).
Publisher Copyright:
© 2015 Association for Professionals in Infection Control and Epidemiology, Inc.
PY - 2015/6/1
Y1 - 2015/6/1
N2 - Background The National Healthcare Safety Network (NHSN) classifies surgical procedures into 40 categories. The objective of this study was to determine surgical site infection (SSI) incidence for clinically defined subgroups within 5 heterogeneous NHSN surgery categories. Methods This is a retrospective cohort study using the longitudinal State Inpatient Database. We identified 5 groups of surgical procedures (amputation; bile duct, liver or pancreas [BILI]; breast; colon; and hernia) using ICD-9-CM procedure codes in community hospitals in California, Florida, and New York from January 2009-September 2011 in persons aged ≥18 years. Each of these 5 categories was classified to more specific surgical procedures within the group. The 90-day SSI rates were calculated using ICD-9-CM diagnosis codes. Results There were 62,901 amputation surgeries, 33,358 BILI surgeries, 72,058 breast surgeries, 125,689 colon surgeries, and 85,745 hernia surgeries in 349,298 people. The 90-day SSI rates varied significantly within each of the 5 subgroups. Within the BILI category, bile duct, pancreas, and laparoscopic liver procedures had SSI rates of 7.2%, 17.2%, and 2.2%, respectively (P <.0001 for each) compared with open liver procedures (11.1% SSI). Conclusion The 90-day SSI rates varied widely within certain NHSN categories. Risk adjustment for specific surgery type is needed to make valid comparisons between hospitals.
AB - Background The National Healthcare Safety Network (NHSN) classifies surgical procedures into 40 categories. The objective of this study was to determine surgical site infection (SSI) incidence for clinically defined subgroups within 5 heterogeneous NHSN surgery categories. Methods This is a retrospective cohort study using the longitudinal State Inpatient Database. We identified 5 groups of surgical procedures (amputation; bile duct, liver or pancreas [BILI]; breast; colon; and hernia) using ICD-9-CM procedure codes in community hospitals in California, Florida, and New York from January 2009-September 2011 in persons aged ≥18 years. Each of these 5 categories was classified to more specific surgical procedures within the group. The 90-day SSI rates were calculated using ICD-9-CM diagnosis codes. Results There were 62,901 amputation surgeries, 33,358 BILI surgeries, 72,058 breast surgeries, 125,689 colon surgeries, and 85,745 hernia surgeries in 349,298 people. The 90-day SSI rates varied significantly within each of the 5 subgroups. Within the BILI category, bile duct, pancreas, and laparoscopic liver procedures had SSI rates of 7.2%, 17.2%, and 2.2%, respectively (P <.0001 for each) compared with open liver procedures (11.1% SSI). Conclusion The 90-day SSI rates varied widely within certain NHSN categories. Risk adjustment for specific surgery type is needed to make valid comparisons between hospitals.
KW - National Healthcare Safety Network
KW - Risk adjustment
KW - Surgical site infection
KW - Surveillance
UR - http://www.scopus.com/inward/record.url?scp=84931560403&partnerID=8YFLogxK
U2 - 10.1016/j.ajic.2015.02.012
DO - 10.1016/j.ajic.2015.02.012
M3 - Article
C2 - 25818024
AN - SCOPUS:84931560403
SN - 0196-6553
VL - 43
SP - 617
EP - 623
JO - American Journal of Infection Control
JF - American Journal of Infection Control
IS - 6
ER -