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. 2015 Jun;43(6):617-23.
doi: 10.1016/j.ajic.2015.02.012. Epub 2015 Mar 26.

Procedure-specific surgical site infection incidence varies widely within certain National Healthcare Safety Network surgery groups

Mohammed J Saeed  1 , Erik R Dubberke  2 , Victoria J Fraser  2 , Margaret A Olsen  3
Affiliations

Procedure-specific surgical site infection incidence varies widely within certain National Healthcare Safety Network surgery groups

Mohammed J Saeed et al. Am J Infect Control. 2015 Jun.

Abstract

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.

Keywords: National Healthcare Safety Network; Risk adjustment; Surgical site infection; Surveillance.

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Figure 1
Figure 1
Inclusion/exclusion criteria algorithm that resulted in final population
See this image and copyright information in PMC

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