Surgical site infection risk factors identified for patients undergoing colon procedures, New York State 2009-2010

Since 2007, New York State (NYS) hospitals have been required to report surgical site infections (SSIs) following colon procedures to the NYS Department of Health, using the National Healthcare Safety Network (NHSN). The purpose of this study was to identify risk factors for the development of SSIs in patients undergoing colon procedures.

NYS has been conducting validation studies at hospitals to assess the accuracy of the surveillance data reported by the participating hospitals. A sample of patients undergoing colon procedures in NYS hospitals were included in hospital-acquired infection program validation studies in 2009 and 2010. Medical chart reviews and on-site visits were performed to verify patient information reported and to evaluate additional risk factors for SSI. Bivariable and multivariable logistic regressions were performed.

A total of 2,656 colon procedures were included in this analysis, including 698 SSI cases. Multivariable analysis indicated that SSI following colon procedure was associated with body mass index greater than 30 (odds ratio [OR], 1.48 [95% confidence interval (CI), 1.21-1.80]), male sex (OR, 1.34 [95% CI, 1.10-1.64]), American Society of Anesthesiologists physical classification score greater than 3 (OR, 1.33 [95% CI, 1.08-1.64]), procedure duration, transfusion (OR, 1.32 [95% CI, 1.05-1.66]), left-side colon surgical procedures, other gastroenterologic procedures, irrigation, hospital bed size greater than 500, and medical school affiliation.

Male sex, obesity, transfusion, type of procedure, and prolonged duration were significant factors associated with overall infection risk after adjusting other factors. Additional factors not collected in the NHSN slightly improved prediction of SSIs.