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Published on: May 26, 2023
Differences in surgical site infection rates by state according to state-mandated operating room air changes per hour
Andrew Atkinson1, Jonas Marschall2, Jason P Burnham3
1Division of Infectious Diseases, Washington University in St. Louis School of Medicine, 4523 Clayton Avenue, Campus Box 8051, St. Louis, MO, 63110, USA.
Background:
Air changes per hour (ACH) in operating rooms (ORs) are energy intensive, and optimal air change settings are not known.
Objectives:
We sought to explore whether there is a relationship between surgical site infections (SSIs) across states based on their state-mandated ACHs.
Design:
Ecological, descriptive, cross-sectional study of publicly reported SSI data in the United States.
Methods:
Wilcoxon test was used to investigate differences between SSI rates for specific surgery types between ACH mandate levels (15 and 20 ACH). Uni- and multivariable Poisson models at the state level were fitted to estimate differences in SSI rates for each surgery type.
Results:
OR ACH mandates and SSIs were positively correlated for C-sections and spinal fusion; negatively correlated for colon and laminectomy surgery.
Conclusion:
For most surgery types, there is no correlation between state-mandated OR ACH. Further studies are needed to determine what changes to mandates can be made safely and effectively.
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