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Applicability of Two Surgical-Site Infection Risk Indices to Risk of Sepsis in Surgical Patients

Published online by Cambridge University Press:  02 January 2015

Concepción Fariñas-Álvarez ,
M. Carmen Fariñas ,
Dolores Prieto  and
Miguel Delgado-Rodríguez
Concepción Fariñas-Álvarez
Affiliation:
Division of Preventive Medicine and Public Health, University of Cantabria School of Medicine, Santander, Spain
M. Carmen Fariñas
Affiliation:
Infectious Diseases Unit, University Hospital “Marqués de Valdecilla,”Santander, Spain
Dolores Prieto
Affiliation:
Division of Preventive Medicine and Public Health, University of Cantabria School of Medicine, Santander, Spain
Miguel Delgado-Rodríguez*
Affiliation:
Division of Preventive Medicine and Public Health, University of Cantabria School of Medicine, Santander, Spain
*
Division of Preventive Medicine and Public Health, University of Cantabria School of Medicine, Av Cardenal Herrera Oria s/n, 39011-Santander, Spain
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Abstract

Objective:

To compare the ability of the Study of the Efficacy of Nosocomial Infection Control (SENIC) and the National Nosocomial Infection Surveillance (NNIS) indices to predict the development of nosocomial sepsis in subjects undergoing surgery.

Design:

1-year prospective case-control study.

Setting:

A tertiary-care center in Spain.

Patients:

Cases were surgical patients with nosocomial sepsis defined using the criteria of the Consensus Conference on Sepsis, identified by daily prospective surveillance.

Methods:

Controls were randomly selected from the daily list of surgical inpatients. Data were prospectively collected. To determine whether either index added explanatory information to the other, two methods were used. The first method involved computing a set of residuals for both variables. Residuals and primary variables were introduced in logistic regression models. The second method evaluated both indices with the Goodman-Kruskal (G) nonparametric coefficient.

Results:

99 cases and 97 controls were included. After controlling for confounders, both the SENIC index (P<.001) and the NNIS index (P=.04) showed a significant trend. Residuals of the SENIC index added discriminating ability to the NNIS index, whereas residuals of the NNIS index did not improve the prediction ability of the SENIC index. Similar results were yielded by the G statistic: the SENIC index showed higher predictive power than the NNIS index (G=0.56 vs G=0.41).

Conclusions:

Both indices performed about equally well for discriminating risk of nosocomial sepsis. The SENIC index had a somewhat better ability than the NNIS index only when the number of discharge diagnoses (not truly a predictive factor) were involved in the calculation of the SENIC index.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 21 , Issue 10 , October 2000 , pp. 633 - 638
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2000

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