PMID- 28758616
OWN - NLM
STAT- MEDLINE
DCOM- 20180514
LR  - 20200111
IS  - 1559-6834 (Electronic)
IS  - 0899-823X (Linking)
VI  - 38
IP  - 9
DP  - 2017 Sep
TI  - Variable Case Detection and Many Unreported Cases of Surgical-Site Infection 
      Following Colon Surgery and Abdominal Hysterectomy in a Statewide Validation.
PG  - 1091-1097
LID - 10.1017/ice.2017.134 [doi]
AB  - OBJECTIVE To assess hospital surgical-site infection (SSI) identification and 
      reporting following colon surgery and abdominal hysterectomy via a statewide 
      external validation METHODS Infection preventionists (IPs) from the California 
      Department of Public Health (CDPH) performed on-site SSI validation for surgical 
      procedures performed in hospitals that voluntarily participated. Validation 
      involved chart review of SSI cases previously reported by hospitals plus review 
      of patient records flagged for review by claims codes suggestive of SSI. We 
      assessed the sensitivity of traditional surveillance and the added benefit of 
      claims-based surveillance. We also evaluated the positive predictive value of 
      claims-based surveillance (ie, workload efficiency). RESULTS Upon validation 
      review, CDPH IPs identified 239 SSIs following colon surgery at 42 hospitals and 
      76 SSIs following abdominal hysterectomy at 34 hospitals. For colon surgery, 
      traditional surveillance had a sensitivity of 50% (47% for deep incisional or 
      organ/space [DI/OS] SSI), compared to 84% (88% for DI/OS SSI) for claims-based 
      surveillance. For abdominal hysterectomy, traditional surveillance had a 
      sensitivity of 68% (67% for DI/OS SSI) compared to 74% (78% for DI/OS SSI) for 
      claims-based surveillance. Claims-based surveillance was also efficient, with 1 
      SSI identified for every 2 patients flagged for review who had undergone 
      abdominal hysterectomy and for every 2.6 patients flagged for review who had 
      undergone colon surgery. Overall, CDPH identified previously unreported SSIs in 
      74% of validation hospitals performing colon surgery and 35% of validation 
      hospitals performing abdominal hysterectomy. CONCLUSIONS Claims-based 
      surveillance is a standardized approach that hospitals can use to augment 
      traditional surveillance methods and health departments can use for external 
      validation. Infect Control Hosp Epidemiol 2017;38:1091-1097.
FAU - Calderwood, Michael S
AU  - Calderwood MS
AD  - 1Section of Infectious Disease and International Health,Dartmouth Hitchcock 
      Medical Center,Lebanon,New Hampshire.
FAU - Huang, Susan S
AU  - Huang SS
AD  - 2Division of Infectious Diseases,University of California Irvine School of 
      Medicine,Orange,California.
FAU - Keller, Vicki
AU  - Keller V
AD  - 3Healthcare-Associated Infections Program,California Department of Public 
      Health,Richmond,California.
FAU - Bruce, Christina B
AU  - Bruce CB
AD  - 4Department of Population Medicine,Harvard Medical School and Harvard Pilgrim 
      Health Care Institute,Boston,Massachusetts.
FAU - Kazerouni, N Neely
AU  - Kazerouni NN
AD  - 3Healthcare-Associated Infections Program,California Department of Public 
      Health,Richmond,California.
FAU - Janssen, Lynn
AU  - Janssen L
AD  - 3Healthcare-Associated Infections Program,California Department of Public 
      Health,Richmond,California.
LA  - eng
GR  - R18 HS021424/HS/AHRQ HHS/United States
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, U.S. Gov't, P.H.S.
DEP - 20170731
PL  - United States
TA  - Infect Control Hosp Epidemiol
JT  - Infection control and hospital epidemiology
JID - 8804099
RN  - 0 (Anti-Bacterial Agents)
SB  - IM
MH  - Abdomen/*surgery
MH  - Anti-Bacterial Agents/therapeutic use
MH  - California
MH  - Clinical Audit
MH  - Colon/surgery
MH  - Cross Infection/*diagnosis/drug therapy/etiology
MH  - Digestive System Surgical Procedures/*adverse effects
MH  - Drug Utilization
MH  - Hospitals
MH  - Humans
MH  - Hysterectomy/*adverse effects/methods
MH  - Insurance Claim Reporting
MH  - International Classification of Diseases
MH  - Sensitivity and Specificity
MH  - Sentinel Surveillance
MH  - Surgical Wound Infection/*diagnosis/drug therapy
MH  - Terminology as Topic
EDAT- 2017/08/02 06:00
MHDA- 2018/05/15 06:00
CRDT- 2017/08/01 06:00
PHST- 2017/08/02 06:00 [pubmed]
PHST- 2018/05/15 06:00 [medline]
PHST- 2017/08/01 06:00 [entrez]
AID - S0899823X17001349 [pii]
AID - 10.1017/ice.2017.134 [doi]
PST - ppublish
SO  - Infect Control Hosp Epidemiol. 2017 Sep;38(9):1091-1097. doi: 
      10.1017/ice.2017.134. Epub 2017 Jul 31.