A Prognostic Scoring Tool for Cesarean Organ/Space Surgical Site Infections: Derivation and Internal Validation

Abstract

This scoring tool showed a high predictive ability regarding cesarean organ/space SSIs on the derivation data and reproducibility was demonstrated on internal validation. It could assist practitioners prioritize patient care and management depending on risk category and decrease SSI rates in cesarean deliveries.

Organ-Space Surgical Site Infections: Consequences and Prediction Using ACS-NSQIP

“…Our study also included several different surgical types which not only increased the generalizability of our findings, but also confirmed what has been found in previous studies evaluating OSIs amongst more specific and individual surgical operations. [7][8][9][10][11][12][13][14][15][16][17][18] However, a limitation to our study was the large percentage of patients that presented for elective surgery which could have biased our results. Additionally, other limitations include its retrospective nature as well as the potential bias introduced given the number of included predictor variables in our statistical model.…”

“…Here, we build on the current literature to identify risk factors that demonstrate distinct associations with superficial, deep, and organ site infections. [7][8][9][10][11][12][13][14][15][16][17][18] Our multivariable model cindex of .846 can be compared to the current NSQIP model c-index of .807, in which all SSIs are grouped together in one measure. By stratifying and specifying OSIs separate from superficial and deep infections, we have increased the predictive power of identifying which patients may develop an OSI.…”

“…2 This possibility was suggested by Lawson et al, 2 who built on several other studies that similarly investigated this hypothesis and evaluated risk factors specific to OSIs. [7][8][9][10][11][12][13][14][15][16][17][18] While no unifying set of predictive factors have been identified, different risk factors have been shown to significantly increase the risk of OSIs among certain stratified patient subsets. For example, postoperative diagnoses including ulcerative colitis and Crohn disease have been identified as risk factors specific to OSIs among colorectal cancer patients, 2 while preoperative albumin and case length have been identified as factors for biliary stenting patients.…”