Does stratifying surgical site infection rates by the National Nosocomial Infection Surveillance risk index influence the rank order of the hospitals in a surveillance system?

Brümmer, S.; Brandt, Christian; Sohr, Dorit; Gastmeier, Petra

doi:10.1016/j.jhin.2008.05.011

Cited by 12 publications

(6 citation statements)

References 21 publications

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“…First of all, the sample size of this study is relatively small, and it may be not sensitive enough to detect the potential risk factors related to intracranial infection. Secondly, previous study [ 41 ] has reported that the national-nosocomial-infection-surveillance-risk-index (NNIS) may be an influencing factor for infection in neurosurgery patients, limited by the clinical data, we failed to include NNIS and other possible influencing factors for stratified analysis. Thirdly, we did not have the information regarding pathogens involved, it’s necessary to evaluate the number of gram-positive vs gram-negative infections, and the predictors of infections could be different, further investigations on those issues are needed in the future.…”

Section: Discussionmentioning

confidence: 99%

RETRACTED ARTICLE: The risk factors of intracranial infection in patients with intracerebral hemorrhage undergone hematoma puncture: what should we care

Han¹,

Yu²,

Liu³

et al. 2020

BMC Infect Dis

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Background Intracranial infection after puncture of cerebral hematoma in patients with intracerebral hemorrhage is very common in the department of neurosurgery, yet the relevant risks remain unknown. We attempted to analyze the risk factors of intracranial infection after puncture of cerebral hematoma, to provide insights into the management of patients with intracerebral hemorrhage after puncture of cerebral hematoma. Methods Patients with intracerebral hemorrhage after puncture of cerebral hematoma treated in our hospital from January 2017 to January 2020 were selected, the related characteristics of intracranial infection and no infection patients were compared. Logistic regression analyses were conducted to analyze the risk factors for intracranial infection after puncture of cerebral hematoma. Results A total of 925 patients with puncture of cerebral hematoma were included. The incidence of postoperative intracranial infection was 7.03%. There were significant statistical differences between the infected group and the no infection group in the American Association of Anesthesiologists (ASA) grade, length of hospital stay, consecutive operation, duration of surgery, extra-ventricular drainage (EVD) use (all p < 0.05). There was statistically significant difference in the duration of EVD between the infection and no infection groups (p = 0.002), and there was no significant difference in the frequency of EVD insertion between the two groups (p = 0.094). The length of hospital stay≥10 days (OR1.832, 1.062–3.158), consecutive operation (OR2.158, 1.358–3.430), duration of surgery≥4 h (OR1.581, 1.031–2.425), EVD use (OR1.694, 1.074–2.670), and duration of EVD ≥ 7 days (OR2.699, 1.689–4.311) were the risk factors of intracranial infection in patients with intracerebral hemorrhage after puncture of cerebral hematoma (all p < 0.05). Conclusion Clinical medical workers should take corresponding preventive measures against the different risk factors for prevention of intracranial infection in patient with puncture of cerebral hematoma.

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Section: Discussionmentioning

confidence: 99%

RETRACTED ARTICLE: The risk factors of intracranial infection in patients with intracerebral hemorrhage undergone hematoma puncture: what should we care

Han¹,

Yu²,

Liu³

et al. 2020

BMC Infect Dis

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“…The alternative would be to recommend crude SSI rates for benchmarking because they are easier to interpret and are associated with a lower workload. Crude SSI benchmarking rates should also be considered because stratifying SSI rates by the NNIS risk index does not influence the rank order of the hospitals in a surveillance system, as demonstrated by previous research [9].…”

Section: Discussionmentioning

confidence: 99%

Prolonged duration of operation: an indicator of complicated surgery or of surgical (mis)management?

et al. 2011

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“…However, contrary to what we expected, our results suggest that SSI risk was similar among all operated patients and hospitals. Brummer et al 8 also ranked hospitals, although they used a different methodology. Their study covered 12 procedures, including HPRO and KPRO.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 Feedback on SSI rates can inform efforts to reduce SSIs, [3][4][5][6][7] therefore, the data presented should be simple, timely, and clear. 8 The overall crude rates for both superficial and deep SSIs are widely used when the national surveillance networks provide feedback to participating hospitals. However, extra caution must be taken when comparing hospitals because the differences may be related to varying patient populations (ie, case mix) and/or varying surveillance methods in hospitals, sensitivity of case finding, type of medical procedures undertaken, and so on.…”

Section: Infect Control Hosp Epidemiol 2017;38:423-429mentioning

confidence: 99%

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Interhospital Comparison of Surgical Site Infection Rates in Orthopedic Surgery

Skufca

Ollgren

Virtanen

et al. 2017

Infect. Control Hosp. Epidemiol.

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OBJECTIVE To investigate whether comparison by deep or adjusted deep surgical site infection (SSI) rates in orthopedic surgeries are a better basis for feedback to Finnish hospitals than overall SSI rates DESIGN Retrospective cohort study SETTING Hospitals conducting surveillance of hip arthroplasties (HPROs) and knee arthroplasties (KPROs) in the Finnish Hospital Infection Program METHODS We analyzed surveillance data for 73,227 HPROs and 56,860 KPROs performed in 18 hospitals during 1999-2014. For each hospital, the overall, deep, and adjusted deep SSI rates with 95% confidence intervals (CIs) were calculated, and the hospital ranks were simulated in the Bayesian framework. Adjustments were performed using relevant patient and hospital characteristics. The correlation between the median expected hospital ranks in overall versus deep SSI rates and deep vs adjusted deep SSI rates were assessed using Spearman's correlation coefficient ρ. RESULTS For HPRO, the overall SSI rates ranged from 0.92 to 6.83, the deep SSI rates ranged from 0.34 to 1.86, and the adjusted deep hospital-specific SSI rates ranged from 0.37 to 1.85. For KPRO, the overall SSI rates ranged from 0.71 to 5.03, the deep SSI rates ranged from 0.42 to 1.60, and the adjusted deep hospital-specific SSI rates ranged from 0.56 to 1.55. For both procedures, the 95% CIs of the rates between hospitals largely overlapped; only single outliers were detected. Hospital rank did not correlate between overall and deep SSI rates (HPRO, ρ=0.03; KPRO, ρ=0.40), but a correlation was observed in hospital rank for deep and adjusted deep SSI rates (HPRO, ρ=0.85; KPRO, ρ=0.94). CONCLUSION Deep SSI rates may be a better tool for interhospital comparisons than overall SSI rates. Although the adjustment could lead to fairer hospital ranking, it is not always necessary for feedback. Infect Control Hosp Epidemiol 2017;38:423-429.

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Does stratifying surgical site infection rates by the National Nosocomial Infection Surveillance risk index influence the rank order of the hospitals in a surveillance system?

Cited by 12 publications

References 21 publications

RETRACTED ARTICLE: The risk factors of intracranial infection in patients with intracerebral hemorrhage undergone hematoma puncture: what should we care

RETRACTED ARTICLE: The risk factors of intracranial infection in patients with intracerebral hemorrhage undergone hematoma puncture: what should we care

Prolonged duration of operation: an indicator of complicated surgery or of surgical (mis)management?

Interhospital Comparison of Surgical Site Infection Rates in Orthopedic Surgery

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