External Validation of SENIC and NNIS Scores for Predicting Wound Infection in Colorectal Surgery

Tezcan Akin,Hüseyin Berkem,Merve Akin,Süleyman Hengirmen,Yiğit Yildiz,Bülent Yüksel,Mesut Tez,Serdar Topaloğlu

doi:10.4236/ss.2011.22016

Abstract

Objective: We aimed to identify the ratio of Surgical Site Infection (SSI) and also the validity of the National Nosocomial Infection Survellance (NNIS) and Study on the Efficacy of Nosocomial Infection Control (SENIC) risk indexes in colorectal surgery, among Turkish population. Background: Some problems have been reported with the power of NNIS risk index to predict the risk of surgical site infection. We aimed to validate theNNIS and SENIC risk indexes in colorectal surgery. Methods: Between January 2003 and December 2006, surgical site ?nfection survellance was performed to 107 patient who undergo colorectal surgery with NNIS and SENIC risk scales. The mean patient age was 48 years (range, 17 to 86), and 61.7% of the group (66) was female. For this patient cohort, 6 (5.6%) were diagnosed with incisional SSI. While the mean Body Mass Index (BMI) of all patients was 26.6; mean value of BMI among the patiens with SSI was 27.8.Results: 6 insicional surgical site infection were observed during the study. According to Receiver Operating Characteric (ROC) curve analyze neither NNIS with avalue of 0.70, nor SENIC with a value of 0.67 are perfect risk indexes. Conclusion: As a result both NNIS and SENIC ?s a good risk indexes but not perfect. Scarcely when NNIS and SENIC is used together to predict the SSI they forecast the development of infection better. But there is a lot of other factors that effect the development of SSI, so for excellent surveillance risk index those factors known by everyone must be added to risk index scales.

Highlights

Surgical site infection (SSI) is the most frequently reported infection among surgical patients, acconting for 14% to 16% of all nosocomial infections among hospitalized patients. [10] These infections are associated with significant morbidity and considerably extend the length of hospital stay.Surveillance has been described as a prevantive measure for reducing such infections. [3] A succesfull surveillance system that uses standart definitions, which feedsback data on-site-specific, risk-adjusted Surgical Site Infection (SSI) rates may provide a measure of quality performance for surgeons and hospitals and contribute to the prevention of hospital acquired infections. [11]For many years wound contamination class was the only factor that was well described for predicting the risk for SSI
We aimed to identify the ratio of Surgical Site Infection (SSI) and the validity of the National Nosocomial Infection Surveillance (NNIS) and Study on the Efficacy of Nosocomial Infection Control (SENIC) risk indexes in colorectal surgery, among Turkish population
İf area under the receiver–operator characteristic (aROC) is 1this means that the procedure analyzed is perfect so the SENIC and NNIS are good but not perfect

Summary

Introduction

Surgical site infection (SSI) is the most frequently reported infection among surgical patients, acconting for 14% to 16% of all nosocomial infections among hospitalized patients. [10] These infections are associated with significant morbidity and considerably extend the length of hospital stay.Surveillance has been described as a prevantive measure for reducing such infections. [3] A succesfull surveillance system that uses standart definitions, which feedsback data on-site-specific, risk-adjusted SSI rates may provide a measure of quality performance for surgeons and hospitals and contribute to the prevention of hospital acquired infections. [11]For many years wound contamination class was the only factor that was well described for predicting the risk for SSI. Surgical site infection (SSI) is the most frequently reported infection among surgical patients, acconting for 14% to 16% of all nosocomial infections among hospitalized patients. Surveillance has been described as a prevantive measure for reducing such infections. [3] A succesfull surveillance system that uses standart definitions, which feedsback data on-site-specific, risk-adjusted SSI rates may provide a measure of quality performance for surgeons and hospitals and contribute to the prevention of hospital acquired infections. For many years wound contamination class was the only factor that was well described for predicting the risk for SSI. During the Study on the Efficacy of Nosocomial Infection Control (SENIC) Project, an index was developed that provided a better assesment of the risk of SSI than had the traditional wound classification system.

Methods

Results

Conclusion