Chronic Disease Score as a Predictor of Surgical Site Infection
Author Information
Author(s): Keith S. Kaye, Kenneth Sands, James G. Donahue, K. Arnold Chan, Paul Fishman, Richard Platt
Primary Institution: Beth Israel Deaconess Medical Center and Harvard Medical School
Hypothesis
Can the chronic disease score improve the prediction of surgical site infections compared to the ASA score?
Conclusion
The chronic disease score is a strong predictor of surgical site infection and may provide better risk stratification than the ASA score.
Supporting Evidence
- The chronic disease score improved prediction of infection by the NNIS risk index.
- Patients with higher chronic disease scores had a higher proportion of surgical site infections.
- The ASA score and chronic disease score were strongly correlated (r=0.58, p<0.001).
- An NNIS-like index based on both the chronic disease and ASA scores performed better than the conventional NNIS index.
Takeaway
Doctors can use a score based on a patient's chronic diseases to better predict if they will get an infection after surgery, which is sometimes better than using the ASA score.
Methodology
A nested case-control study comparing 191 patients with surgical site infections to 372 uninfected controls, using chronic disease scores derived from pharmacy data.
Potential Biases
The matching process for controls may have underestimated the associations between surgical site infection and risk indices.
Limitations
The study was limited to a single hospital, which may affect the generalizability of the results.
Participant Demographics
Mean age of participants was 51 years, with a mix of male and female patients undergoing nonobstetric surgeries.
Statistical Information
P-Value
p<0.001
Confidence Interval
95% CI 1.5-4.7
Statistical Significance
p<0.05
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