Sangsuwan Tharntip, Jamulitrat Silom, Watcharasin Pattharapa
Department of Family Medicine and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand.
Ann Med Surg (Lond). 2022 May 7;77:103715. doi: 10.1016/j.amsu.2022.103715. eCollection 2022 May.
Risk stratifications to predict development of surgical site infections (SSI) are crucial methods before surgery. Hence, we aimed to compare the performance of risk adjustment between the former NNIS risk index and the new NHSN procedure-specific risk model for postoperative colorectal SSI.
A retrospective cohort study was conducted. Data of post-colorectal SSI, indicating the use of the NNIS risk index for SSI adjustment, were retrieved from the medical records. Data were taken from patients who underwent colorectal surgery procedures between January 2005 and December 2016. Additional information regarding emergency colorectal surgery was retrieved to fulfill the requirements for calculation of the risks for SSI; via the new model. The predictive performance between the two models was compared using the means of the area under the receiver operating characteristic curve.
In total 1989 patients were included. Fifteen patients were excluded; thus, the remaining number of procedures was 1974. Surgical site infections occurred in 85 (4.3%) procedures. In colectomy surgery, the means of area under the curve (AUC) yielded 0.6196 and 0.5976 for the NNIS risk index model and the new NHSN risk model, respectively; differences in the AUC were not statistically significant (p = 0.39). In rectal surgery, the means of the AUC yielded 0.516 and 0.49 for the NNIS risk index model and the new NHSN procedure-specific risk model, respectively; differences in the AUC were not statistically significant (p = 0.56).
The new NHSN procedure-specific risk model was not superior to the former NNIS risk index.
术前预测手术部位感染（SSI）发生情况的风险分层是至关重要的方法。因此，我们旨在比较既往的NNIS风险指数与新的NHSN特定手术风险模型在结直肠术后SSI风险调整方面的表现。
进行了一项回顾性队列研究。从病历中检索了结直肠术后SSI的数据，这些数据表明使用了NNIS风险指数进行SSI调整。数据取自2005年1月至2016年12月期间接受结直肠手术的患者。检索了有关急诊结直肠手术的其他信息，以满足通过新模型计算SSI风险的要求。使用受试者操作特征曲线下面积的均值比较了两种模型的预测性能。
共纳入1989例患者。排除15例患者；因此，剩余手术例数为1974例。85例（4.3%）手术发生了手术部位感染。在结肠切除术手术中，NNIS风险指数模型和新NHSN风险模型的曲线下面积（AUC）均值分别为0.6196和0.5976；AUC差异无统计学意义（p = 0.39）。在直肠手术中，NNIS风险指数模型和新NHSN特定手术风险模型的AUC均值分别为0.516和0.49；AUC差异无统计学意义（p = 0.56）。
新的NHSN特定手术风险模型并不优于既往的NNIS风险指数。
