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Predicting organ space surgical site infection with a nomogram
Luiz F de Campos-Lobato1, Luiz F Campos-Lobato, Brian Wells
1Department of Colorectal Surgery, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
Summary
A new predictive model can identify patients at risk for organ space surgical site infections (organ space SSI) after bowel surgery. This validated nomogram aids in risk stratification and modification for better patient outcomes.
Area of Science:
- Surgical Infections
- Predictive Modeling
- Gastrointestinal Surgery
Background:
- Organ space surgical site infections (organ space SSI) are a distinct category of surgical site infections.
- Unique risk factors may be associated with organ space SSI.
Purpose of the Study:
- To develop a predictive model for organ space SSI following small bowel, colon, or rectal operations.
- To identify unique risk factors contributing to organ space SSI.
Main Methods:
- Utilized the 2006 American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database (N = 12,373).
- Included variables such as patient demographics, comorbidities, and surgical factors to build the predictive model.
- Excluded patients with preoperative conditions like sepsis or wound infection.
Main Results:
- The developed organ space SSI model demonstrated a concordance index of 0.65 upon validation with 2007 ACS-NSQIP data (N = 9,521).
- A risk calculator based on this model is publicly available online.
Conclusions:
- The study presents a novel, validated nomogram for predicting organ space SSI in patients undergoing small bowel, colon, and rectal surgery.
- This tool can be valuable for risk stratification and guiding risk modification strategies to improve surgical outcomes.