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Tag: administrative claims|article link|claims data|risk factors|spinal surgery

Surgical Site Infection (SSI) in Spinal Surgery: Description of Surgical and Patient-Based Risk Factors for Postoperative Infection Using Administrative Claims Data.

By wp_zaman

Surgical Site Infection (SSI) in Spinal Surgery: Description of Surgical and Patient-Based Risk Factors for Postoperative Infection Using Administrative Claims Data.

Spine (Phila Pa 1976). 2011 Dec 28;

Authors: Abdul-Jabbar A, Takemoto S, Weber MH, Hu SS, Mummaneni PV, Deviren V, Ames CP, Chou D, Weinstein PR, Burch S, Berven SH

Abstract
Study Design. Retrospective AnalysisObjective. The objective of this study was to investigate the accuracy of using an automated approach to administrative claims data to assess the rate and risk factors for surgical site infection in spinal procedures.Summary of Background Data. Surgical site infection (SSI) is a major indicator of health care quality. A wide range of SSI rates have been proposed in the literature depending on clinical setting and procedure type.Methods. All spinal surgeries performed at a university-affiliated tertiary-care center from July 2005- December 2010 were identified using diagnosis related group (DRG), current procedural terminology (CPT) and international classification of disease (ICD-9) codes and validated through chart review. Rates of SSI and associated risk factors were calculated using univariate regression analysis. Odds ratios were calculated through multivariate logistic regression.Results. A total of 6,628 hospital visits were identified. The cumulative incidence of SSI was 2.9%. Procedural risk factors associated with a statistically significant increase in rates of infection were: sacral involvement (9.6%), fusions greater than seven levels (7.8%), fusions greater than 12 levels (10.4%), cases with an osteotomy (6.5%), operative time longer than 5 hours (5.1%), transfusions of red blood cells (5.0%), serum (7.4%) and autologous blood (4.1%). Patient based risk factors included: anemia (4.3%), diabetes mellitus (4.2%), coronary artery disease (4.7%), diagnosis of coagulopathy (7.8%) and bone or connective tissue neoplasm (5.0%).Conclusion. Used individually, DRG, CPT and ICD-9 codes cannot completely capture a patient population. Using an algorithm combining all three coding systems to generate both inclusion and exclusion criteria, we were able to analyze a specific population of spinal surgery patients within a high volume medical center. Within that group, risk factors found to increase infection rates were isolated and can serve to focus hospital-wide efforts to decrease surgery-related morbidity and improve patient outcomes.

PMID: 22210012 [PubMed – as supplied by publisher]