Risk Factor | Evidence | Modifiable? | Patient | Perioperative | Surgeon |
---|---|---|---|---|---|
Age | N | Y | |||
Gender | N | Y | |||
Body Mass Index | II | N | Y | ||
Comorbidity Score | N | Y | |||
Diabetes | II | N | Y | ||
Chronic Lung Disease | N | Y | |||
Chronic Kidney Disease | N | Y | |||
Peripheral vascular disease | N | Y | |||
Prior site irradiation | N | Y | |||
Recent operation | N | Y | |||
Skin carriage of staphylococci | N | Y | |||
Skin disease in the area of infection (eg, psoriasis) | N | Y | |||
Wound Class | I | N | Y | ||
Emergent Procedure | N | Y | |||
ASA Score | I | N | Y | ||
Revision/Re-do Operation | N | Y | |||
Pre-Op Hospitalization | N | Y | |||
Hx of MRSA | N | Y | |||
Post-Op Wound Care by Nurse | Y | Y | |||
Hospitalizations in Prior 12 Months | N | Y | |||
Surgical Site | N | Y | |||
Anesthetic Drugs | Y | Y | |||
Hx Rheumatologic Disease | N | Y | |||
Previous Surgical Site Infection | N | Y | |||
Instututionalized | N | Y | |||
NNIS Risk Index | I | N | Y | ||
Glucose Control | Y | Y | |||
Hypocholesterolemia | Y | Y | |||
Preoperative anemia | Y | Y | |||
Postoperative anemia | Y | Y | |||
Remote infection | Y | Y | |||
Malnutrition | Y | Y | |||
Smoking | Y | Y | |||
Outpatient Surgery | Y | Y | |||
Inpatient Surgery | Y | Y | |||
Staph Aureus Colonization | Y | Y | |||
Preoperative Shower | Y | Y | |||
Immunosuppressive Drugs Pre-Op | Y | Y | |||
Pre-Op Albumin Level | Y | ||||
Ascites | Y | ||||
Chronic inflammation | Y | ||||
Corticosteroid therapy w/in 30 Days | Y | ||||
Duration of Surgery (min) | N | Y | |||
Tourniquet Time | N | Y | |||
Post-Op Mechanical Ventilation | N | Y | |||
Laminar Airflow OR | Y | Y | |||
HEPA Filtered OR | Y | Y | |||
Laparoscopic Approach | I | Y | Y | ||
General Anesthesia | Y | Y | |||
Post-Op Admit | Y | Y | |||
ICU Admission Post-Op | Y | Y | |||
Perioperative Hyperoxia (FiO2 80%) | Y | Y | |||
Timely Pre-Op Abx | I | Y | Y | ||
Appropriate Pre-op Abx | II | Y | Y | ||
Discontinuation of Post-Op Abx <24 hr | III | Y | Y | ||
Appropriate Intra-Op Re-dosing of Abx | Y | Y | |||
Lowest Intra-Op Temperature | I | Y | Y | ||
Temperature on Arrival to PACU | I | Y | Y | ||
Peri-Op Glucose <100 | Y | Y | |||
Peri-Op Glucose <200 | Y | Y | |||
Peri-Op Transfusion | II | Y | Y | ||
Skin Prep | I | Y | Y | ||
Hair Removal | II | Y | Y | ||
Abx Irrigation | Y | Y | |||
Injections into Wound (e.g., Local Anesthetic) | Y | Y | |||
Implant | Y | Y | |||
Tissue expander use | D | ||||
Daily living assistance needed | M | ||||
Excessive blood loss; > 1 liter | M | ||||
Suture material (Deep, and in wound) | D | ||||
Incision method | M | ||||
Frequency of glove change | U | ||||
Subcutaneous hematoma | D if ICD9 or M | ||||
Hx of cancer | D | ||||
Periop allogeneic blood transfusion | M for periop | ||||
Interop vasopressor | D | ||||
preop mechanical ventilation | LL | ||||
Hx of abx allergy | LL | ||||
Preop urinary catheterization | LL | ||||
Skin closure method | M | ||||
Periop lapse in discipline? | ?? | ||||
Transfer from another hospital | D | ||||
Tumor necrosis factor blockers | D | ||||
Development of DVT | D | ||||
Intraop inspired O2 < 50% | M | ||||
Duration of hypothermia; < 35.5 | D for approx. time | ||||
Tracheotomy | D | ||||
Bowel or bladder dysfunction | D | ||||
No. of surgeons scrubbed | D | ||||
Hx of COPD | D |
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Improving the Measurement of Surgical Site Infection Risk Stratification/Outcome Detection
Appendix I. Initial Risk Factors
Table of Contents
- Improving the Measurement of Surgical Site Infection Risk Stratification/Outcome Detection
- Executive Summary
- Chapter 1. Administration
- Chapter 2. Determining Surgical Site Infection Rates
- Chapter 3. Designing and Testing Methods to Stratify Risk of Surgical Site Infections
- Chapter 4. Assessing Surgeon Acceptance of Risk Adjustment Models
- Chapter 5. Project Expansion
- Chapter 6. Conclusions and Recommendations
- References
- Appendix A. Teleconferences with AHRQ & CDC
- Appendix B. In-Person Meetings
- Appendix C. Data Dictionary
- Appendix D. Mapping ICD9 and CPT Codes
- Appendix E. Culture Type Map to Procedure Types
- Appendix F. Algorithms
- Appendix G. Pairwise Correlation of Variables with SSI and with Each Other
- Appendix H. Calculating Sensitivity and Specificity for Validation
- Appendix I. Initial Risk Factors
- Appendix J. Additional Risk Factors
- Appendix K. Final Risk Factors
- Appendix L. Final data sheet submitted by each site that included the list of potential SSI risk factors and other pertinent variables
- Appendix M. Master Risk Factor List with Final Bolded
- Appendix N. Surgeon Focus Group Guide
- Appendix O. Nursing Focus Group Guides
- Appendix P. Focus Group Risk Factors
- Appendix Q. Surgeon Focus Group Content Analysis
- Appendix R. Infection Prevention Support Tool
- Appendix S. Surgeons' Acceptance of Surgical Site Infection Risk Adjustment Models
- Appendix T. Surgical Infection Society Abstract
- Appendix U. Improving the Measurement of Surgical Site Infection (SSI) Risk Stratification and Outcome Detection
- Appendix V. JAMIA Draft Manuscript
Publication: 12-0046-EF
Page last reviewed April 2018
Page originally created December 2012
Internet Citation: Appendix I. Initial Risk Factors. Content last reviewed April 2018. Agency for Healthcare Research and Quality, Rockville, MD.
https://www.ahrq.gov/research/findings/final-reports/ssi/ssiapi.html