ANALYSIS OF RISK FACTORS FOR SURGICAL SITE INFECTION: A CASE RESEARCH IN AN ORTHOPEDIC HOSPITAL (HEALTHCARE INDUSTRY)

This study portrays a ranked structure on different risk factors including patient, surgery and hospital related risk factors and allied unfavorable outcomes concerning an orthopedic hospital. The paper suggests a methodical surgical site infection (SSI) risk assessment method for assessing level of risk factors using three vital quantifying elements; outcome, time and likelihood of exposure. To transform the linguistic data into numeric risk scores, an enhanced decision making technique using fuzzy set theory has been endeavored in this paper. The notion of ‘centre of area’ technique for widespread TFNs has been discovered to measure the ‘extent of risk’ with regard to crisp scores. Lastly, a reasonable structure for classifying risk factors into various risk levels has been built based on differentiated ranges of assessed crisp risk scores. Then, an activity necessity plan has been proposed, which could give direction to the officials for effectively controlling risk factors in the circumstance of orthopedic hospital.

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Incidence and risk factors of surgical site infection following colorectal surgery in China: a national cross-sectional study

BMC Infectious Diseases ◽

10.1186/s12879-020-05567-6 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Xufei Zhang ◽

Zhiwei Wang ◽

Jun Chen ◽

Peige Wang ◽

Suming Luo ◽

...

Keyword(s):

Risk Factors ◽

Colorectal Surgery ◽

Surgical Site Infection ◽

Large Scale ◽

Risk Index ◽

Cross Sectional Study ◽

Site Infection ◽

Cross Sectional ◽

Medical Expenses ◽

Related Risk

Abstract Purposes Surgical site infection (SSI) after colorectal surgery is a frequent complication associated with the increase in morbidity, medical expenses, and mortality. To date, there is no nationwide large-scale database of SSI after colorectal surgery in China. The aim of this study was to determine the incidence of SSI after colorectal surgery in China and to further evaluate the related risk factors. Methods Two multicenter, prospective, cross-sectional studies covering 55 hospitals in China and enrolling adult patients undergoing colorectal surgery were conducted from May 1 to June 30 of 2018 and the same time of 2019. The demographic and perioperative characteristics were collected, and the main outcome was SSI within postoperative 30 days. Multivariable logistic regressions were conducted to predict risk factors of SSI after colorectal surgery. Results In total, 1046 patients were enrolled and SSI occurred in 74 patients (7.1%). In the multivariate analysis with adjustments, significant factors associated with SSI were the prior diagnosis of hypertension (OR, 1.903; 95% confidence interval [CI], 1.088–3.327, P = 0.025), national nosocomial infection surveillance risk index score of 2 or 3 (OR, 3.840; 95% CI, 1.926–7.658, P < 0.001), laparoscopic or robotic surgery (OR, 0.363; 95% CI, 0.200–0.659, P < 0.001), and adhesive incise drapes (OR, 0.400; 95% CI, 0.187–0.855, P = 0.018). In addition, SSI group had remarkably increased length of postoperative stays (median, 15.0 d versus 9.0d, P < 0.001), medical expenses (median, 74,620 yuan versus 57,827 yuan, P < 0.001), and the mortality (4.1% versus 0.3%, P = 0.006), compared with those of non-SSI group. Conclusion This study provides the newest data of SSI after colorectal surgery in China and finds some predictors of SSI. The data presented in our study can be a tool to develop optimal preventive measures and improve surgical quality in China.

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Incidence and risk factors of surgical site infection following colorectal surgery in Iran: a prospective cohort study

10.21203/rs.3.rs-272952/v1 ◽

2021 ◽

Author(s):

Siamak Rajaei ◽

Masoud Mohammadi ◽

Mohammad Hosein Taziki Balajelini ◽

Reza Afghani ◽

Mehrshad Zare ◽

...

Keyword(s):

Risk Factors ◽

Colorectal Surgery ◽

Surgical Site Infection ◽

Colon Surgery ◽

Site Infection ◽

Prospective Design ◽

Related Risk ◽

Scientific Principles ◽

Golestan Province ◽

Univariate Analyses

Abstract Background Surgical site infection (SSI) after colorectal surgery remains a significant problem for its negative clinical outcomes. The aim of this study was to determine the incidence of SSI after colorectal surgery in 5-Azar hospital of Gorgan, Golestan province, Iran and to further evaluate the related risk factors. Methods A prospective design was applied. Patients in the 5-Azar hospital of Gorgan, Golestan province, Iran was prospectively monitored for SSI after colorectal surgery. The demographic and perioperative characteristics were collected, and the main outcome were SSI within postoperative 30 days. Univariate analyses were used to identify risk factors. Results A total of 240 patients were enrolled in the study and the overall SSI rate was 23.3% (56 patients). Univariate analyses indicated that corticosteroids use (Risk Ratio (RR) = 3, 95% CI: 1.62–5.54), segmental resection with anastomosis (RR = 2.28, 95% CI: 1.12–4.63), anemia (RR = 4.52, 95% CI: 3.11–6.59), diabetics (RR = 2.68, 95% CI: 1.73–4.14), and opium use (RR = 1.87, 95% CI: 1.17–2.99) are risk factors for SSI. Conclusions SSI still seems to be a problem in colon surgery despite the observance of scientific principles. There are some risk factors for SSI that can be prevented.

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Incidence, risk factors and Microorganisms for post caesarean Surgical Site Infection In A Tertiary Care Centre in Bangladesh

Journal of Dhaka Medical College ◽

10.3329/jdmc.v28i2.51148 ◽

2021 ◽

Vol 28 (2) ◽

pp. 136-141

Author(s):

Shahfinaz Mehzabin ◽

Mohmmad Mahbub Elahi ◽

Debashish Bar ◽

Banalata Sinha ◽

Tahmina Akter ◽

...

Keyword(s):

Risk Factors ◽

Caesarean Section ◽

Surgical Site Infection ◽

Surgical Site Infections ◽

Site Infection ◽

Medical College ◽

Related Risk ◽

Microbiological Methods ◽

Duration Of Surgery ◽

History Of

Background: Surgical site infection (SSI) is a common complication following caesarean section (C-section) and mainly responsible for increased maternal morbidity and higher treatment costs. This study will determine the incidence and risk factors of surgical site infections following caesarean section in Dhaka Medical College Hospital (DMCH). Materials and Methods: This is a retrospective observational study which was conducted among patients having post caesarean surgical site infections attending post-natal outdoor clinic of DMCH from January, 2019 to December, 2019. Data were collected in structured questionnaire. Culturebased microbiological methods were used to identify causal agents in postoperative wounds. Results: Overall SSI rate following caesarian section was 4.44%.Patient related risk factors were inadequate antenatal check-up, emergency procedures, malnutrition (22.44%), anaemia (21.46%) associated comorbidity (59.46%), history of rupture membrane >12 hours (40.98%) and had history of prolonged labour pain >12 hours (16.10%).Surgery related risk factors were repeated per vaginal examinations by untrained birth attendant (21.95%) & duration of surgery>1 hour (62.93%). The most common organisms responsible for SSI were Staphylococcus aureus 44(21.46%) and Escherichia coli 31(15.12%). The most sensitive antibiotics were aminoglycosides, cephalosporin & cloxacillin. Conclusion: Most of the risk factors for surgical site infection following caesarean section identified in this study can be modified through intervention. However the microorganisms detected from our patient showed a high degree of resistance for commonly prescribed antimicrobials in our set-up. J Dhaka Medical College, Vol. 28, No.2, October, 2019, Page 136-141

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Patient-related risk factors for surgical site infection following eight types of gastrointestinal surgery

Journal of Hospital Infection ◽

10.1016/j.jhin.2016.04.005 ◽

2016 ◽

Vol 93 (4) ◽

pp. 347-354 ◽

Cited By ~ 14

Author(s):

H. Fukuda

Keyword(s):

Risk Factors ◽

Surgical Site Infection ◽

Gastrointestinal Surgery ◽

Site Infection ◽

Related Risk

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Evaluation of patient related modifiable and non-modifiable risk factors in causation of surgical site infection in various abdominal surgeries

International Surgery Journal ◽

10.18203/2349-2902.isj20185485 ◽

2018 ◽

Vol 6 (1) ◽

pp. 265

Author(s):

Abhinav Agrawal ◽

Shivam Madeshiya ◽

Roshni Khan ◽

Shashank S. Tripathi ◽

Gaurav Bharadwaj

Keyword(s):

Risk Factors ◽

Surgical Site Infection ◽

Surgical Site Infections ◽

Signs And Symptoms ◽

Blood Transfusions ◽

Site Infection ◽

Case Scenario ◽

Related Risk ◽

Duration Of Surgery ◽

Before And After

Background: Surgical Site Infection (SSI) is second commonest nosocomial complication in surgical speciality. Majority of surgical wounds are contaminated by microbes, but in most cases, infection does not develop because innate host defense are quite efficient in elimination of contaminants. The objective of this study was to evaluate patient related risk factors in causation of surgical site infection in various abdominal surgeries.Methods: All patients who admitted in surgical OPD/emergency and undergoing abdominal surgical procedures were included in study. This observational study was comprised of 952 subjects. Patients were observed in wards and during follow up to assess signs and symptoms of surgical site infection.Results: Result were analysed in terms of age, sex, distribution of cases based on case scenario (elective v/s emergency), wound class, type of surgery (laparoscopic v/s open), smoking, diabetes, duration of surgery, complete hemogram before and after blood transfusion, number of blood transfusions, albumin, blood sugar level, discharge from surgical site, number of days of drains, stoma and hospital stay.Conclusions: Surgical site infection in emergency cases were found to be higher as compared to elective cases. Occurrence of SSI proportionately increased with degree of contamination, duration of surgery and age of patients. Laparoscopic procedures showed fewer incidences of surgical site infection as compared to open procedures. Various factors showed statistically significant association with surgical site infections were diabetes, smoking, blood transfusions, haemoglobin and albumin levels. Presence of stomas and drains were associated with increased incidence of SSI but could not be proven statistically.

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Risk Factors for Surgical Site Infection in Head and Neck Cancer

10.21203/rs.3.rs-512387/v1 ◽

2021 ◽

Author(s):

chengwen gan ◽

yannan wang ◽

yan tang ◽

kai wang ◽

bingcan sun ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Head And Neck Cancer ◽

Surgical Site Infection ◽

Head And Neck ◽

Site Infection ◽

Tumor Site ◽

Floor Of Mouth ◽

Flap Failure ◽

Related Risk

Abstract Purpose Surgical site infection (SSI) frequently occurs in patients with head and neck cancer (HNC) after tumor resection and can lead to death in severe cases. Moreover, there is no definitive conclusion about the risk factors of SSI. Therefore, it is of great clinical significance to study the factors affecting the SSI. Methods The HNC patients included in this study were all from the Department of Oral and Maxillofacial Surgery of the Second Xiangya Hospital of Central South University (CSU), and these patients received surgical treatment in the department from January 2018 to December 2019. Univariate and multivariate regression analysis was applied to determine the risk factors of SSI. To identify the key risk factors of SSI, the caret package was used to construct three different machine learning models to investigate important features involving 26 SSI-related risk factors. Results Participants were 632 HNC patients who underwent surgery in our department from January 2018 to December 2019. During the postoperative period, 82 patients suffered from SSI and surgical site infection rate (SSIR) was about 12.97%. Diabetes mellitus, tumor site (floor of mouth) and flap failure were consistently ranked the top three in the 26 SSI-related risk factors. In addition, SSI can increase postoperative hospital stays and flap failure rate. Conclusion Diabetes mellitus, tumor site (floor of mouth), flap failure, preoperative radiotherapy, neck dissection (bilateral) are risk factors for SSI of HNC.

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A Filtering Approach to Ergonomics Surveillance

Proceedings of the Human Factors and Ergonomics Society Annual Meeting ◽

10.1177/1071181397041001158 ◽

1997 ◽

Vol 41 (1) ◽

pp. 722-724

Author(s):

J. Murray Gibson ◽

David C. Alexander

Keyword(s):

Risk Factors ◽

High Risk ◽

Employee Turnover ◽

Low Risk ◽

Risk Scores ◽

Moderate Risk ◽

Risk Levels ◽

Related Risk ◽

Filtering Approach ◽

Ergonomic Risk Factors

There is a need in industry for practical surveillance methods to identify ergonomics problems. Most conventional surveillance methods have the following characteristics: • Require completion of a multi-page checklist for every job in the facility. • Identify, in a “single-pass” survey, all jobs presenting a moderate to low level of ergonomic-related risk, resulting in an “unmanageable” list of problems. • Provide job risk scores used to prioritize every ergonomics problem in the facility. The author presents an alternative surveillance methodology which identifies and prioritizes high, moderate, and low risk jobs using a “filtering approach”. This filtering approach actually consists of three separate checklists, each identifying (or filtering) for jobs of different risk levels: High Risk Survey, Moderate Risk Survey, and Low Risk Survey. Each checklist utilizes data from three sources: ergonomic risk factors, loss information, and employee turnover/complaints.

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“Patient-Related Risk Factors For Superficial Surgical Site Infection And The Correlation To Periprosthetic Joint Infection – A 5year Follow-up Of 1291 Elective Primary Total Joint Arthroplasties”

10.21203/rs.3.rs-41920/v1 ◽

2020 ◽

Author(s):

Hannah K Eriksson ◽

Stergios Lazarinis

Keyword(s):

Risk Factors ◽

Surgical Site Infection ◽

Risk Ratio ◽

Periprosthetic Joint Infection ◽

Joint Infection ◽

Knee Surgery ◽

Site Infection ◽

Related Risk ◽

Increased Risk ◽

Male Patients

Abstract Background: The incidence of superficial surgical site infection (SSSI) may increase the risk of subsequent periprosthetic joint infection (PJI). Optimisation or even avoiding patient-related risk factors for SSSI preoperatively, may decrease the risk of subsequent PJI. Purpose: To identify patient-related risk factors associated with SSSI and investigate their correlation with the progression of PJI. Methods: 1,291 primary elective hip and knee prosthesis were included. Patients were personally contacted by a nurse ≥ 3 month after surgery to answer questions about the postoperative period, including any occurrences of SSSI. The diagnosed PJI was determined by an orthopaedic surgeon together with a specialist in infectious diseases, and all patients with PJI underwent revision surgery. The patient-related risk factors considered relevant were joint, age, sex, American Society of Anesthesiologists classification (ASA), body mass index (BMI), smoking, diabetes and rheumatological disease. Results: 7,0 % of included patients developed an SSSI, and 1,9 % a PJI. Factors with a significantly increased adjusted risk ratio for SSSI were; knee surgery 1,9 (95% CI: 1,2 – 3,1), age ≥ 65 years 1,7 (95% CI: 1,1 – 2,8), BMI ≥35 2,3 (95% CI: 1,2 – 4,2) and for PJI; knee surgery 2,6 (95% CI: 1,1 – 6,4), ASA-class ≥ 3 3,2 (95% CI: 1,3 – 7,9), BMI ≥35 3,0 (95% CI: (1,2 – 4,2) and male gender 3,0 (95% CI: (1,2 – 7,5). Male patients showed a significant risk of developing PJI following SSSI, with a risk ratio of 3,3 (95% CI: 1,1 – 10,5).Conclusions: Male patients planned for total knee prostheses (TKA) aged 65 or over, with high ASA-class and high BMI should be selected with care due to the increased risk of postoperative infection.

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Correlation of perioperative risk scores with hospital costs in neurosurgical patients

Journal of Neurosurgery ◽

10.3171/2018.10.jns182041 ◽

2020 ◽

Vol 132 (3) ◽

pp. 818-824

Author(s):

Sasha Vaziri ◽

Joseph M. Abbatematteo ◽

Max S. Fleisher ◽

Alexander B. Dru ◽

Dennis T. Lockney ◽

...

Keyword(s):

Surgical Site Infection ◽

Hospital Costs ◽

Patient Characteristics ◽

Risk Scores ◽

Site Infection ◽

Risk Calculator ◽

Surgical Risk ◽

Acs Nsqip ◽

Neurosurgical Patients ◽

Predicted Risk

OBJECTIVEThe American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) online surgical risk calculator uses inherent patient characteristics to provide predictive risk scores for adverse postoperative events. The purpose of this study was to determine if predicted perioperative risk scores correlate with actual hospital costs.METHODSA single-center retrospective review of 1005 neurosurgical patients treated between September 1, 2011, and December 31, 2014, was performed. Individual patient characteristics were entered into the NSQIP calculator. Predicted risk scores were compared with actual in-hospital costs obtained from a billing database. Correlational statistics were used to determine if patients with higher risk scores were associated with increased in-hospital costs.RESULTSThe Pearson correlation coefficient (R) was used to assess the correlation between 11 types of predicted complication risk scores and 5 types of encounter costs from 1005 health encounters involving neurosurgical procedures. Risk scores in categories such as any complication, serious complication, pneumonia, cardiac complication, surgical site infection, urinary tract infection, venous thromboembolism, renal failure, return to operating room, death, and discharge to nursing home or rehabilitation facility were obtained. Patients with higher predicted risk scores in all measures except surgical site infection were found to have a statistically significant association with increased actual in-hospital costs (p < 0.0005).CONCLUSIONSPrevious work has demonstrated that the ACS NSQIP surgical risk calculator can accurately predict mortality after neurosurgery but is poorly predictive of other potential adverse events and clinical outcomes. However, this study demonstrates that predicted high-risk patients identified by the ACS NSQIP surgical risk calculator have a statistically significant moderate correlation to increased actual in-hospital costs. The NSQIP calculator may not accurately predict the occurrence of surgical complications (as demonstrated previously), but future iterations of the ACS universal risk calculator may be effective in predicting actual in-hospital costs, which could be advantageous in the current value-based healthcare environment.

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