title: Predicting organ space surgical site infection with a nomogram.
abstract: OBJECTIVE
  We hypothesized that organ space surgical site infections (organ space SSI) are a unique type of surgical site infection and therefore are associated with a unique set of risk factors. The aim of this study was to create a predictive model for organ space SSI after small bowel, colon, or rectal operations.
  
  
  METHODS
  The 2006 American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) sample (N = 12,373) was used to identify current procedural terminology codes for small bowel, colon, and rectal laparoscopic or open surgical procedures. The following variables were used to build a predictive model of organ space SSI within 30 days post-op: age, gender, body mass index, American Society of Anesthesiologists class, smoking, diabetes, steroid use, 30 days previous radiotherapy or surgery, preoperative serum creatinine and albumin, laparoscopic surgery, wound class, perioperative transfusion, operative time, and surgical site. Patients on chronic mechanical ventilation, dialysis, wound infection, or sepsis preoperatively were excluded.
  
  
  RESULTS
  Our organ space SSI model achieved a concordance index of 0.65 when validated in 2007 ACS-NSQIP patients (N = 9,521). A risk calculator designed based upon our model is available at www.clinicriskcalculators.com .
  
  
  CONCLUSIONS
  This novel and validated nomogram is useful to predict organ space SSI associated with small bowel, colon, and rectal surgical procedures. It may also be useful for risk stratification and risk modification.
authors.affiliation: Department of Colorectal Surgery, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
authors.forename: Luiz F
authors.initials: LF
authors.lastname: de Campos-Lobato
authors.forename: Luiz F
authors.initials: LF
authors.lastname: Campos-Lobato
authors.forename: Brian
authors.initials: B
authors.lastname: Wells
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Wick
authors.forename: Kevin
authors.initials: K
authors.lastname: Pronty
authors.forename: Ravi
authors.initials: R
authors.lastname: Kiran
authors.forename: Feza
authors.initials: F
authors.lastname: Remzi
authors.forename: Jon D
authors.initials: JD
authors.lastname: Vogel
mesh_terms: D000368:Aged; D003082:Colectomy; D013505:Digestive System Surgical Procedures; D005260:Female; D006801:Humans; D007081:Ileostomy; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D049451:Nomograms; D016737:Proctocolectomy, Restorative; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology*