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Factors Associated With Risk of Surgical Wound Infections

Penn State College of Medicine, Hershey, Pennsylvania, chollenbeak{at}psu.edu

Judith R. Lave, PhD

University of Pittsburgh, Pennsylvania

Timothy Zeddies, PhD

Independence Blue Cross, Philadelphia, Pennsylvania

Yanfen Pei, MS

Pennsylvania Health Care Cost Containment Council, Harrisburg

Constance E. Roland, MA

Pennsylvania Health Care Cost Containment Council, Harrisburg

Eugene F. Sun, MD

HealthAmerica, Pittsburgh, Pennsylvania

Surgical wound infections are the most common hospital-acquired infections among patients who undergo inpatient surgery. Risk of infection is a function of both patient susceptibility and exposure. The authors studied all discharges in Pennsylvania from October 1, 2004, through September 30, 2005, in which a circulatory (n= 65 940), neurological (n= 6706), or orthopedic (n = 107 825) procedure was performed using data from the Pennsylvania Health Care Cost Containment Council. They estimated the impact of patient-specific factors on risk of infection and compared the ability of these factors to predict infections relative to hospital effects. Results suggested that for all 3 types of procedures, patient-specific factors were a significant determinant of risk of surgical wound infection. However, prediction of infection was improved by 23% to 33% when hospital fixed effects were included. Although patient-specific factors had a statistically significant association with risk of infections, much of the risk of surgical wound infections is determined by hospital factors.

Key Words: surgical wound infections • hospital-acquired infections • risk factors • hospitals

American Journal of Medical Quality, Vol. 21, No. 6 suppl, 29S-34S (2006)
DOI: 10.1177/1062860606294602


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