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Risk Factors of Brophy et al for Surgical Site Infection After Orthopedic Surgery Performed in an Ambulatory Care Center

Description

Brophy et al identified factors affecting the rate of surgical site infections (SSI) following orthopedic surgery performed in an ambulatory care center. This can help to identify a patient who may benefit from more aggressive management. The auth0rs are from Washington University and Barnes-Jewish West County Hospital in St. Louis.


Patient selection: orthopedic surgery performed in an ambulatory care center

 

Outcome: surgical site infection

 

Incidence of SSI: 0.32%

 

Parameters:

(1) age in years

(2) diabetes mellitus

(3) tourniquet time in minutes

(4) anesthesia type

(5) anatomic site of surgery

 

Parameter

Finding

Adjusted Odds Ratio

age in years

< 70 years

1

 

>= 70 years

2.85

diabetes

no

1

 

yes

2.27

tourniquet time in minutes

 

(1.01^(minutes))

anesthesia type

general

1

 

regional

0.272

 

combined

4.49

anatomic site

shoulder

1

 

foot or ankle

11.2

 

hand or elbow

4.01

 

knee or leg

6.75

 

hip

18.6

 

multiple sites

2.04

 

combined odds ratios =

= PRODUCT(adjusted odds ratios for all 5 parameters)

 

Interpretation:

• minimum combined OR: 0.272

• maximum combined OR: 1783 (affected by tourniquet time duration)

• The higher the combined odds rations the greater the risk for SSI.


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