Effect of National Healthcare Safety Network (NHSN) Definition Changes on Colon Surgical Site Infection (SSI) Rates

2014 ◽  
Vol 42 (6) ◽  
pp. S12
Author(s):  
Jeanne A. Yegge ◽  
Kathleen Gase ◽  
Melinda Hohrein ◽  
Raya Khoury ◽  
Hilary Babcock
Keyword(s):  
Surgical Site Infection ◽  
Site Infection ◽  
National Healthcare ◽  
National Healthcare Safety Network

scholarly journals Incidence of Surgical Site Infection Following Mastectomy With and Without Immediate Reconstruction Using Private Insurer Claims Data

2015 ◽  
Vol 36 (8) ◽  
pp. 907-914 ◽  
Author(s):  
Margaret A. Olsen ◽  
Katelin B. Nickel ◽  
Ida K. Fox ◽  
Julie A. Margenthaler ◽  
Kelly E. Ball ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Claims Data ◽  
Diverse Population ◽  
Site Infection ◽  
Immediate Reconstruction ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Diagnosis Codes ◽  
Unilateral Mastectomy ◽  
Procedure Type

OBJECTIVEThe National Healthcare Safety Network classifies breast operations as clean procedures with an expected 1%–2% surgical site infection (SSI) incidence. We assessed differences in SSI incidence following mastectomy with and without immediate reconstruction in a large, geographically diverse population.DESIGNRetrospective cohort studyPATIENTSCommercially insured women aged 18–64 years with ICD-9-CM procedure or CPT-4 codes for mastectomy from January 1, 2004 through December 31, 2011METHODSIncident SSIs within 180 days after surgery were identified by ICD-9-CM diagnosis codes. The incidences of SSI after mastectomy with and without immediate reconstruction were compared using the χ2 test.RESULTSFrom 2004 to 2011, 18,696 mastectomy procedures among 18,085 women were identified, with immediate reconstruction in 10,836 procedures (58%). The incidence of SSI within 180 days following mastectomy with or without reconstruction was 8.1% (1,520 of 18,696). In total, 49% of SSIs were identified within 30 days post-mastectomy, 24.5% were identified 31–60 days post-mastectomy, 10.5% were identified 61–90 days post-mastectomy, and 15.7% were identified 91–180 days post-mastectomy. The incidences of SSI were 5.0% (395 of 7,860) after mastectomy only, 10.3% (848 of 8,217) after mastectomy plus implant, 10.7% (207 of 1,942) after mastectomy plus flap, and 10.3% (70 of 677) after mastectomy plus flap and implant (P<.001). The SSI risk was higher after bilateral compared with unilateral mastectomy with immediate reconstruction (11.4% vs 9.4%, P=.001) than without (6.1% vs 4.7%, P=.021) immediate reconstruction.CONCLUSIONSSSI incidence was twice that after mastectomy with immediate reconstruction than after mastectomy alone. Only 49% of SSIs were coded within 30 days after operation. Our results suggest that stratification by procedure type facilitates comparison of SSI rates after breast operations between facilities.Infect Control Hosp Epidemiol 2015;36(8):907–914

scholarly journals Clinical implications of restrictions in criteria for defining surgical site infections after mastectomy

2020 ◽  
pp. 1-3
Author(s):  
Antoinette A. A. Bediako-Bowan ◽  
David K. Warren ◽  
Katelin B. Nickel ◽  
Victoria J. Fraser ◽  
Margaret A. Olsen
Keyword(s):  
Surgical Site Infection ◽  
Surgical Site Infections ◽  
Adverse Outcomes ◽  
Clinical Implications ◽  
Site Infection ◽  
National Healthcare ◽  
National Healthcare Safety Network

Abstract More than 50% of women with clinically apparent infection after mastectomy did not meet the 2020 National Healthcare Safety Network (NHSN) definition for surgical site infection (SSI). Implant loss was similar whether the 2020 NHSN SSI definition was met or not, suggesting equivalent adverse outcomes regardless of restriction to the surveillance definition.

Comparison of hospital surgical site infection rates and rankings using claims versus National Healthcare Safety Network surveillance data

2018 ◽  
Vol 40 (2) ◽  
pp. 208-210 ◽  
Author(s):  
Chanu Rhee ◽  
Rui Wang ◽  
Maximilian S. Jentzsch ◽  
Carly Broadwell ◽  
Heather Hsu ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Colon Surgery ◽  
Surveillance Data ◽  
Site Infection ◽  
Infection Rates ◽  
Medical Claims ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Network Surveillance ◽  
Healthcare Associated

AbstractNational policies target healthcare-associated infections using medical claims and National Healthcare Safety Network surveillance data. We found low concordance between the 2 data sources in rates and rankings for surgical site infection following colon surgery in 155 hospitals, underscoring the limitations in evaluating hospital quality by claims data.

Improving Risk-Adjusted Measures of Surgical Site Infection for the National Healthcare Safely Network

2011 ◽  
Vol 32 (10) ◽  
pp. 970-986 ◽  
Author(s):  
Yi Mu ◽  
Jonathan R. Edwards ◽  
Teresa C. Horan ◽  
Sandra I. Berrios-Torres ◽  
Scott K. Fridkin
Keyword(s):  
Surgical Site Infection ◽  
Risk Index ◽  
Operative Procedure ◽  
Univariate Analysis ◽  
Predictive Performance ◽  
Stepwise Logistic Regression ◽  
Site Infection ◽  
Risk Models ◽  
National Healthcare ◽  
Specific Risk

Background.The National Healthcare Safety Network (NHSN) has provided simple risk adjustment of surgical site infection (SSI) rates to participating hospitals to facilitate quality improvement activities; improved risk models were developed and evaluated.Methods.Data reported to the NHSN for all operative procedures performed from January 1, 2006, through December 31, 2008, were analyzed. Only SSIs related to the primary incision site were included. A common set of patient- and hospital-specific variables were evaluated as potential SSI risk factors by univariate analysis. Some ific variables were available for inclusion. Stepwise logistic regression was used to develop the specific risk models by procedure category. Bootstrap resampling was used to validate the models, and the c-index was used to compare the predictive power of new procedure-specific risk models with that of the models with the NHSN risk index as the only variable (NHSN risk index model).Results.From January 1, 2006, through December 31, 2008, 847 hospitals in 43 states reported a total of 849,659 procedures and 16,147 primary incisional SSIs (risk, 1.90%) among 39 operative procedure categories. Overall, the median c-index of the new procedure-specific risk was greater (0.67 [range, 0.59–0.85]) than the median c-index of the NHSN risk index models (0.60 [range, 0.51–0.77]); for 33 of 39 procedures, the new procedure-specific models yielded a higher c-index than did the NHSN risk index models.Conclusions.A set of new risk models developed using existing data elements collected through the NHSN improves predictive performance, compared with the traditional NHSN risk index stratification.

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