Skip to main content Accessibility help
×
Home

Indices of Surgical Site Infection Risk and Prediction of Other Adverse Outcomes During Hospitalization

  • Miguel Delgado-Rodríguez, Silvia Palma (a1), Antonio Gómez-Ortega (a2), Gabriel Martínez-Gallego (a2) and Marcelino Medina-Cuadros (a2)...

Abstract

Objective.

To assess which adverse postsurgical outcomes are best predicted by the Study on the Efficacy of Nosocomial Infection Control (SENIC) index and the National Nosocomial Infection Surveillance system (NNIS) index.

Design.

Prospective cohort study.

Setting.

The service of general surgery at a tertiary care hospital.

Patients.

A consecutive series of patients hospitalized for more than 1 day (n = 2,989).

Results.

The outcome best predicted by the SENIC and NNIS indices was assessed by estimating the area under the receiver operating characteristic (ROC) curve. The areas under the ROC curves for nosocomial infection and in-hospital death were higher for the NNIS index than they were for the SENIC index (P<.05). The NNIS index predicted in-hospital death better than it predicted surgical site infection (area under the ROC curve ± SE, 0.836 ± 0.022 vs 0.689 ± 0.017; P = .001).

Conclusions.

The NNIS index is superior to the SENIC index for all adverse postsurgical outcomes. Its ability to predict in-hospital mortality is clearly better than its ability to predict surgical site infection.

Copyright

Corresponding author

Health Sciences Building (B-3), University of Jaén, 23071-Jaén, (mdelgado@ujaen.es)

References

Hide All
1. Haley, RW, Culver, DH, Morgan, WM, White, JW, Emori, TG, Hooton, TM. Identifying patients at high risk of surgical wound infection: a simple multivariate index of patient susceptibility and wound contamination. Am J Epidemiol 1985; 121:206215.
2. Culver, DH, Horan, RC, Gaynes, RP, et al, and the National Nosocomial Infections Surveillance System. Surgical wound infection rates by wound class, operative procedure, and patient risk index. Am J Med 1991; 91(Suppl 3B):152S157S.
3. Delgado-Rodríguez, M, Martínez-Gallego, G, Medina-Cuadros, M, Sillero-Arenas, M. Usefulness of intrinsic surgical site infection indices as predictors of post-operative pneumonia risk. J Hosp Infect 1997; 35:269276.
4. Fariñas-Álvarez, C, Fariñas, MC, Prieto, D, Delgado-Rodríguez, M. Applicability of two surgical-site infection risk indices to risk of sepsis in surgical patients. Infect Control Hosp Epidemiol 2000; 21:633638.
5. Delgado-Rodríguez, M, Gómez-Ortega, A, Lecuona, M, et al. Nosocomial infection, indices of intrinsic infection risk, and in-hospital death. J Hosp Infect 1999; 41:203211.
6. Delgado-Rodríguez, M, Medina-Cuadros, M, Martínez-Gallego, G, et al. A prospective study of tobacco smoking as a predictor of complications in general surgery. Infect Control Hosp Epidemiol 2003; 24:3743.
7. Gaynes, RP, Culver, DH, Horan, TC, Edwards, JR, Richards, C, Tolson, JS. Surgical site infection (SSI) rates in the United States, 1992–1998: the National Nosocomial Infections Surveillance System basic SSI risk index. Clin Infect Dis 2001; 33(Suppl 2):S69S77.
8. Garner, JS, Jarvis, WR, Emori, TG, Horan, TC, Hughes, JM. CDC definitions for nosocomial infections. Am J Infect Control 1988; 16:128140.
9. Horan, TC, Gaynes, RP, Martone, WJ, Jarvis, WR, Emori, TG. Centers for Diseases Control (CDC) definitions for nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. Infect Control Hosp Epidemiol 1992; 13:606608.
10. Delgado-Rodríguez, M, Gómez-Ortega, A, Sillero-Arenas, M, Llorca, J. Epidemiology of surgical site infections diagnosed after discharge: a prospective cohort study. Infect Control Hosp Epidemiol 2001; 22:2430.
11. DeLong, ER, DeLong, DM, Clarke-Pearson, DL. Comparing the areas under two or more correlated receiver operating curves: a non-parametric approach. Biometrics 1998; 44:837845.
12. Soleto, L, Pirard, M, Boelaert, M, et al. Incidence of surgical-site infections and the validity of the National Nosocomial Infections Surveillance System risk index in a general surgical ward in Santa Cruz, Bolivia. Infect Control Hosp Epidemiol 2003; 24:2630.

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed