title: Identifying risk factors for surgical site infections in mastectomy patients using the National Surgical Quality Improvement Program database.
abstract: BACKGROUND
  The Centers for Disease Control and Prevention reported that surgical site infections (SSIs) create a significant hospital burden. To date, few multi-institutional studies have been performed to evaluate the risk factors for SSIs in mastectomy patients.
  
  
  METHODS
  By using the American College of Surgeons' National Surgical Quality Improvement Program database, all patients undergoing mastectomy from 2005 to 2009 were identified. The outcome was to determine the incidence rate and identify significant independent risk factors of SSIs.
  
  
  RESULTS
  The incidence of SSI was 2.3% (891 of 38,739; 95% confidence interval, 2.2%-2.5%) in patients undergoing mastectomy without reconstruction. Significant (P < .05) risk factors for SSI included a body mass index greater than 25, American Society of Anesthesiology classification of 3 or higher, diabetes mellitus, surgical time of 2 hours or longer (75th percentile), and current smoking status.
  
  
  CONCLUSIONS
  Before this study, there was wide variation in the incidence rate of surgical site infections in this patient population. This was a large-scale study to address these inconsistencies.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033-0800, USA. Gabrielle.Davis@med.usc.edu
authors.forename: Gabrielle B
authors.initials: GB
authors.lastname: Davis
authors.forename: Mirna
authors.initials: M
authors.lastname: Peric
authors.forename: Linda S
authors.initials: LS
authors.lastname: Chan
authors.forename: Alex K
authors.initials: AK
authors.lastname: Wong
authors.forename: Stephen F
authors.initials: SF
authors.lastname: Sener
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D016208:Databases, Factual; D048909:Diabetes Complications / Q000453:epidemiology; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008408:Mastectomy / Q000009:adverse effects* / Q000379:methods; D008875:Middle Aged; D016017:Odds Ratio; D061646:Operative Time; D058996:Quality Improvement; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D014481:United States / Q000453:epidemiology