Simple Prediction Score for Developing Surgical Site Infection after Clean Neck Operation

Area of Science:

• Surgical Oncology
• Infectious Disease Prevention
• Health Services Research

Background:

• Clean neck operations, including thyroidectomies, parathyroidectomies, and lymph node resections, are common surgical procedures.
• Surgical site infections (SSIs) following these procedures are rare but carry severe, potentially life-threatening consequences.

Purpose of the Study:

• To develop a predictive scoring system to identify patients at high risk for developing SSIs after clean neck surgery.
• To aid in the early identification of at-risk individuals for targeted interventions.

Main Methods:

• Analysis of 99,877 patients undergoing clean neck procedures from the 2016-2017 American College of Surgeons National Surgical Quality Improvement Program database.
• Multivariable logistic regression to identify independent risk factors for post-operative SSI.
• Development of a prognostic score based on identified risk factors.

Main Results:

• Key independent risk factors for SSI included male gender, diabetes mellitus, smoking, pre-operative steroid use, cancer diagnosis, radical lymphadenectomies, and operative time.
• A prognostic score was developed, assigning points to specific risk factors (excluding operative time).
• The developed score demonstrated a stepwise increase in the risk of post-operative SSI.

Conclusions:

• Pre-operative and intra-operative factors are significant predictors of SSI development after clean neck surgery.
• The novel prognostic score can assist surgeons in identifying high-risk patients.
• Patients identified as high-risk may benefit from prophylactic antibiotic administration to reduce SSI incidence.