Risk factors for hospital-based surgical site infections.

Area of Science:

• Medical research
• Surgical outcomes
• Public health

Background:

• Surgical site infections (SSIs) represent a significant cause of patient morbidity and increased healthcare costs.
• Identifying factors associated with SSIs is crucial for developing effective prevention strategies.
• The Nationwide Readmission Database (NRD) provides a valuable resource for analyzing large-scale patient data.

Purpose of the Study:

• To identify patient and hospital-related factors associated with the occurrence of surgical site infections (SSIs).
• To quantify the risk of SSIs based on various demographic, clinical, and hospital characteristics.

Main Methods:

• A case-control study was conducted using data from the Nationwide Readmission Database (NRD).
• Analysis included 45,445 cases of SSIs.
• Statistical analysis, including odds ratios (OR) with 95% confidence intervals (CI), was used to determine associations.

Main Results:

• Obesity (BMI ≥ 30), tobacco use, diabetes, high comorbidity index (Elixhauser ≥ 2), longer hospital stays (4-6 days), and medium-to-large hospitals were associated with increased SSI risk.
• Conversely, lower SSI odds were observed in patients aged 60-79 and ≥ 80, females, underweight individuals (BMI < 18.5), non-metropolitan hospitals, self-pay patients, and Medicare beneficiaries.
• Specific ORs and CIs were provided for each identified factor.

Conclusions:

• Patient factors such as obesity, tobacco use, diabetes, and comorbidities significantly increase SSI risk.
• Hospital characteristics, including size and length of stay, also play a role in SSI development.
• Understanding these diverse factors allows for targeted interventions to reduce the incidence of SSIs and improve patient outcomes.