TY - JOUR
T1 - Risk of surgical site infection (SSI) following colorectal resection is higher in patients with disseminated cancer
T2 - An NCCN member cohort study
AU - Kamboj, Mini
AU - Childers, Teresa
AU - Sugalski, Jessica
AU - Antonelli, Donna
AU - Bingener-Casey, Juliane
AU - Cannon, Jamie
AU - Cluff, Karie
AU - Davis, Kimberly A.
AU - Dellinger, E. Patchen
AU - Dowdy, Sean C.
AU - Duncan, Kim
AU - Fedderson, Julie
AU - Glasgow, Robert
AU - Hall, Bruce
AU - Hirsch, Marilyn
AU - Hutter, Matthew
AU - Kimbro, Lisa
AU - Kuvshinoff, Boris
AU - Makary, Martin
AU - Morris, Melanie
AU - Nehring, Sharon
AU - Ramamoorthy, Sonia
AU - Scott, Rebekah
AU - Sovel, Mindy
AU - Strong, Vivian
AU - Webster, Ashley
AU - Wick, Elizabeth
AU - Aguilar, Julio Garcia
AU - Carlson, Robert
AU - Sepkowitz, Kent
N1 - Publisher Copyright:
© 2018 by The Society for Healthcare Epidemiology of America. All rights reserved.
PY - 2018/5/1
Y1 - 2018/5/1
N2 - BACKGROUND Surgical site infections (SSIs) following colorectal surgery (CRS) are among the most common healthcare-associated infections (HAIs). Reduction in colorectal SSI rates is an important goal for surgical quality improvement.OBJECTIVE To examine rates of SSI in patients with and without cancer and to identify potential predictors of SSI risk following CRSDESIGN American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) data files for 2011-2013 from a sample of 12 National Comprehensive Cancer Network (NCCN) member institutions were combined. Pooled SSI rates for colorectal procedures were calculated and risk was evaluated. The independent importance of potential risk factors was assessed using logistic regression.SETTING Multicenter studyPARTICIPANTS Of 22 invited NCCN centers, 11 participated (50%). Colorectal procedures were selected by principal procedure current procedural technology (CPT) code. Cancer was defined by International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) codes.MAIN OUTCOME The primary outcome of interest was 30-day SSI rate.RESULTS A total of 652 SSIs (11.06%) were reported among 5,893 CRSs. Risk of SSI was similar for patients with and without cancer. Among CRS patients with underlying cancer, disseminated cancer (SSI rate, 17.5%; odds ratio [OR], 1.66; 95% confidence interval [CI], 1.23-2.26; P=.001), ASA score ≥3 (OR, 1.41; 95% CI, 1.09-1.83; P=.001), chronic obstructive pulmonary disease (COPD; OR, 1.6; 95% CI, 1.06-2.53; P=.02), and longer duration of procedure were associated with development of SSI.CONCLUSIONS Patients with disseminated cancer are at a higher risk for developing SSI. ASA score >3, COPD, and longer duration of surgery predict SSI risk. Disseminated cancer should be further evaluated by the Centers for Disease Control and Prevention (CDC) in generating risk-adjusted outcomes.
AB - BACKGROUND Surgical site infections (SSIs) following colorectal surgery (CRS) are among the most common healthcare-associated infections (HAIs). Reduction in colorectal SSI rates is an important goal for surgical quality improvement.OBJECTIVE To examine rates of SSI in patients with and without cancer and to identify potential predictors of SSI risk following CRSDESIGN American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) data files for 2011-2013 from a sample of 12 National Comprehensive Cancer Network (NCCN) member institutions were combined. Pooled SSI rates for colorectal procedures were calculated and risk was evaluated. The independent importance of potential risk factors was assessed using logistic regression.SETTING Multicenter studyPARTICIPANTS Of 22 invited NCCN centers, 11 participated (50%). Colorectal procedures were selected by principal procedure current procedural technology (CPT) code. Cancer was defined by International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) codes.MAIN OUTCOME The primary outcome of interest was 30-day SSI rate.RESULTS A total of 652 SSIs (11.06%) were reported among 5,893 CRSs. Risk of SSI was similar for patients with and without cancer. Among CRS patients with underlying cancer, disseminated cancer (SSI rate, 17.5%; odds ratio [OR], 1.66; 95% confidence interval [CI], 1.23-2.26; P=.001), ASA score ≥3 (OR, 1.41; 95% CI, 1.09-1.83; P=.001), chronic obstructive pulmonary disease (COPD; OR, 1.6; 95% CI, 1.06-2.53; P=.02), and longer duration of procedure were associated with development of SSI.CONCLUSIONS Patients with disseminated cancer are at a higher risk for developing SSI. ASA score >3, COPD, and longer duration of surgery predict SSI risk. Disseminated cancer should be further evaluated by the Centers for Disease Control and Prevention (CDC) in generating risk-adjusted outcomes.
UR - http://www.scopus.com/inward/record.url?scp=85044177770&partnerID=8YFLogxK
U2 - 10.1017/ice.2018.40
DO - 10.1017/ice.2018.40
M3 - Article
C2 - 29553001
AN - SCOPUS:85044177770
SN - 0899-823X
VL - 39
SP - 555
EP - 562
JO - Infection Control and Hospital Epidemiology
JF - Infection Control and Hospital Epidemiology
IS - 5
ER -