Predictive Accuracy of the Complex 30-Day Model for Colon Surgical Site Infections after Traumatic Colon Injury: Any...

Area of Science:

• Trauma Surgery
• Infectious Disease Epidemiology
• Health Services Research

Background:

• Colon surgical site infections (SSIs) present significant clinical and financial challenges.
• The National Healthcare Safety Network (NHSN) Complex 30-Day SSI Model is used for reimbursement by the Centers for Medicare and Medicaid Services.
• This model's accuracy for emergent colon operations in trauma patients is unknown.

Purpose of the Study:

• To evaluate the predictive accuracy of the NHSN Complex 30-Day SSI Model for trauma patients undergoing emergent colon surgery.
• To determine if the current model adequately assesses risk in this specific patient population.

Main Methods:

• Utilized the Trauma Quality Program Participant Use File (2017-2021, excluding 2020).
• Calculated predicted colon SSI probability using NHSN Complex 30-day Model variables.
• Generated Receiver Operating Characteristic (ROC) curves and calculated Area Under the Curve (AUC) for predictive accuracy assessment.

Main Results:

• Included 292,688 patients undergoing emergent colon surgery for trauma.
• Overall SSI rate was 0.33% (1,097 cases).
• The model demonstrated poor predictive accuracy with an AUC of 0.523 (95% CI: 0.506-0.541).

Conclusions:

• The NHSN Complex 30-Day SSI Model exhibits poor predictive accuracy for colon surgery in trauma patients.
• The current model may not fully account for the unique risks and complexities of trauma-related surgery.
• Development of an improved risk assessment model is necessary for accurate patient care and hospital reimbursement.