Evaluation of the SENIC risk index in a Spanish university hospital.
OBJECTIVE
To assess the performance of the Study of the Efficacy of Nosocomial Infection Control (SENIC) risk index for the evaluation of the risk of surgical-site infection (SSI) in a country other than the United States, having a different health system.


METHODS
350-bed university hospital in Spain belonging to the National Health System (Insalud).


METHODS
Observational cohort study of 1,019 patients who underwent consecutive surgery from January to December 1992. Surgical-infection risk factors assessed by the traditional wound-classification system (clean, clean-contaminated, contaminated, and dirty-infected wound) and by the SENIC risk index (length of intervention more than 2 hours, more than three discharge diagnoses, abdominal surgery, and contaminated or dirty-infected wound) were compared by forward logistic regression.


RESULTS
The SENIC risk index showed a greater ability to predict SSI than the traditional wound-classification system. The study carried out in our institution reproduced the estimators provided by the SENIC study in the United States. The SENIC risk index provided a stepwise increase in SSI rates, according to the number of factors present, for every traditional wound-classification group. In the case of clean wounds, the incidence of surgical infection (per 100 interventions) increased (1.5, 2.4, 5.3, and 50; P<.001) for patients having from zero to three risk factors of the SENIC risk index.


CONCLUSIONS
This study shows that the SENIC risk index results are reproducible, and the index can be used to compare rates of wound infection across countries with different health systems than the United States.
Valls
V
V
Department of Preventive Medicine, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain.
Díez
M
M
Ena
J
J
Gutiérrez
A
A
Gómez-Herruz
P
P
Martín
A
A
Gónzalez-Palacios
R
R
Granell
J
J
D000043:Abstracting and Indexing; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D015331:Cohort Studies; D003428:Cross Infection / Q000517:prevention & control*; D005260:Female; D006745:Hospital Bed Capacity, 300 to 499; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods*; D013030:Spain; D013530:Surgical Wound Infection / Q000145:classification* / Q000517:prevention & control*