| Risk Factor | Important | Feasible | Feasible, Difficult (e.g. Chart Review) |
|---|---|---|---|
| Age | 6 | 6 | 0 |
| Gender | 3 | 5 | 0 |
| Body Mass Index | 6 | 4 | 1 |
| Comorbidity Score (Charlson or whatever is available) | 5 | 2 | 1 |
| Diabetes | 6 | 3 | 1 |
| Chronic Lung Disease | 3 | 2 | 1 |
| Chronic Kidney Disease | 3 | 2 | 1 |
| Peripheral vascular disease | 2 | 1 | 1 |
| Prior site irradiation (At any time) | 3 | 1 | 2 |
| Recent operation (Within 30 days) | 5 | 4 | 0 |
| Skin carriage of staphylococci | 3 | 1 | 1 |
| Skin disease in the area of surgery (eg, psoriasis) | 2 | 0 | 1 |
| Wound Class | 6 | 5 | 1 |
| Emergent Procedure | 5 | 5 | 0 |
| ASA Score | 5 | 5 | 0 |
| Revision/Re-do Operation | 4 | 4 | 0 |
| Pre-Op Hospitalization (# of days) | 5 | 5 | 0 |
| Hx of MRSA | 3 | 2 | 1 |
| Homelessness | 1 | 0 | 0 |
| Hospitalizations in Prior 12 Months (#) | 0 | 0 | 0 |
| Surgical Site | 3 | 5 | 0 |
| Insurance/Payor Source | 0 | 1 | 0 |
| Hx Rheumatologic Disease | 1 | 2 | 0 |
| Previous Surgical Site Infection | 5 | 4 | 1 |
| Instututionalized | 2 | 2 | 0 |
| NNIS Risk Index | 4 | 1 | 1 |
| Glucose Control (Hgb A1C and Pre-op Glucose) | 6 | 5 | 0 |
| Hypocholesterolemia | 0 | 1 | 0 |
| Preoperative anemia | 6 | 6 | 0 |
| Postoperative anemia | 3 | 4 | 0 |
| Remote infection | 4 | 3 | 1 |
| Malnutrition (Wt loss, albumin, prealbumin) | 6 | 4 | 1 |
| Smoking | 6 | 6 | 0 |
| Alcohol Abuse | 4 | 5 | 0 |
| Substance Abuse | 1 | 2 | 0 |
| Staph Aureus Colonization | 3 | 2 | 0 |
| Preoperative Shower | 4 | 3 | 0 |
| Immunosuppressive Drugs Pre-Op | 5 | 5 | 0 |
| Pre-Op Albumin Level | 6 | 5 | 0 |
| Ascites | 5 | 2 | 1 |
| Chronic inflammation | 2 | 1 | 1 |
| Corticosteroid therapy w/in 30 Days | 4 | 3 | 0 |
| Duration of Surgery (min) | 6 | 5 | 0 |
| Tourniquet Time | 2 | 2 | 0 |
| Post-Op Mechanical Ventilation | 2 | 2 | 0 |
| Surgeon Experience (# Past 12 Months) | 3 | 2 | 0 |
| Surgeon Age | 0 | 0 | 0 |
| Laparoscopic Approach | 5 | 5 | 0 |
| General Anesthesia | 1 | 2 | 0 |
| No. of Personnel in OR | 3 | 2 | 0 |
| Trainee (Lowest Level) Scrubbed in OR | 2 | 2 | 0 |
| OR Traffic | 1 | 1 | 0 |
| Timely Pre-Op Abx | 6 | 6 | 0 |
| Appropriate Pre-op Abx | 6 | 6 | 0 |
| Discontinuation of Post-Op Abx <24 hr | 4 | 4 | 0 |
| Appropriate Intra-Op Re-dosing of Abx | 5 | 5 | 0 |
| Lowest Intra-Op Temperature | 5 | 5 | 0 |
| Temperature on Arrival to PACU | 5 | 5 | 0 |
| Peri-Op Glucose <100 | 0 | 0 | 0 |
| Peri-Op Glucose <200 | 6 | 4 | 1 |
| Peri-Op Transfusion | 5 | 4 | 1 |
| Skin Prep | 5 | 5 | 0 |
| Hair Removal | 5 | 5 | 0 |
| Abx Irrigation | 1 | 2 | 0 |
| Injections into Wound (e.g., Local Anesthetic) | 0 | 1 | 0 |
| Implant | 3 | 3 | 0 |
| Anesthetic Drugs | 0 | 0 | 0 |
| Outpatient Surgery | 2 | 2 | 0 |
| Inpatient Surgery | 2 | 2 | 0 |
| Post-Op Admit | 1 | 1 | 0 |
| Laminar Airflow OR | 1 | 1 | 0 |
| HEPA Filtered OR | 1 | 1 | 0 |
| Number of Procedures (in same OR session) | 1 | 1 | 0 |
| Use of Drain | 6 | 5 | 0 |
| ICU Admission Post-Op | 1 | 1 | 0 |
| Perioperative Hyperoxia (FiO2 80%) | 3 | 3 | 0 |
| Peri-Op Insulin Administration | 2 | 2 | 0 |
| Peri-Op Proton Pump Inhibitor | 1 | 1 | 0 |
| Peri-Op VTE Prophylaxis | 2 | 2 | 0 |
| Post-Op Wound Care by Nurse | 2 | 2 | 0 |
| Anticoagulation Medication | 2 | 2 | 0 |
| Post-Op Ambulation (What Day?) | 1 | 1 | 0 |
| Liters of IV Fluid in OR | 4 | 4 | 0 |
| Liters of Fluid 24 hrs Post-Op | 2 | 2 | 0 |
| Central Line | 2 | 3 | 0 |
| Pre-Op Hemoglobobin | 5 | 5 | 0 |
| Use of Stryker Suit | 0 | 1 | 0 |
| Surgeon Beard | 0 | 1 | 0 |
| Tissue expander use | 0 | 0 | 0 |
| Daily living assistance needed | 2 | 1 | 0 |
| Excessive blood loss; > 1 liter | 4 | 3 | 0 |
| Suture material (Deep, and in wound) | 4 | 3 | 0 |
| Incision method | 1 | 1 | 0 |
| Frequency of glove change | 1 | 0 | 0 |
| Subcutaneous hematoma | 4 | 2 | 0 |
| Hx of cancer | 2 | 2 | 0 |
| Periop allogeneic blood transfusion | 3 | 3 | 0 |
| Interop vasopressor | 3 | 3 | 0 |
| preop mechanical ventilation | 1 | 1 | 0 |
| Hx of abx allergy | 1 | 2 | 0 |
| Preop urinary catheterization | 2 | 3 | 0 |
| Skin closure method | 3 | 3 | 0 |
| Periop lapse in discipline? | 3 | 1 | 1 |
| Transfer from another hospital | 0 | 1 | 0 |
| Tumor necrosis factor blockers | 0 | 1 | 0 |
| Development of DVT | 0 | 1 | 0 |
| Intraop inspired O2 < 50% | 1 | 2 | 0 |
| Duration of hypothermia; < 35.5 | 4 | 1 | 1 |
| Tracheotomy | 0 | 1 | 0 |
| Bowel or bladder dysfunction | 0 | 0 | 1 |
| No. of surgeons scrubbed | 1 | 2 | 0 |
| Hx of COPD | 1 | 2 | 0 |
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Improving the Measurement of Surgical Site Infection Risk Stratification/Outcome Detection
Appendix K. Final 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 K. Final Risk Factors. Content last reviewed April 2018. Agency for Healthcare Research and Quality, Rockville, MD.
https://www.ahrq.gov/research/findings/final-reports/ssi/ssiapk.html
