title: Using NSQIP to investigate SCIP deficiencies in surgical patients with a high risk of developing hospital-associated urinary tract infections.
abstract: The study objectives were to identify risk factors for surgical patients who develop postoperative urinary tract infections (UTIs) and to characterize urethral catheter practices at the study hospital. Patients from the 2006-2010 institutional National Surgical Quality Improvement Program database were evaluated. Patients with UTIs within 30 postoperative days (n = 116) were compared to patients without UTIs (n = 8685) using multivariable logistic regression. A nested case-control study evaluated the effects of catheter practices on postoperative UTI using conditional logistic regression. Independent predictors of UTI were sex, age, inpatient stay, functional status, renal failure, preoperative transfusion, and preoperative hospital stay. Compared with controls, patients with UTI more often maintained catheters for >2 postoperative days (66% vs 43%, P < .001) and had longer mean catheter duration (11.6 vs 5.1 days, P < .001). Study findings led to institutional recommendations to reduce catheter-associated UTIs. Quality improvement initiatives can increase awareness of performance enhancement opportunities and encourage collaborative, interdisciplinary improvement through shared objectives.
authors.affiliation: Inova Fairfax Hospital, Falls Church, VA.
authors.forename: Amber W
authors.initials: AW
authors.lastname: Trickey
authors.affiliation: Inova Fairfax Hospital, Falls Church, VA.
authors.forename: Moira E
authors.initials: ME
authors.lastname: Crosby
authors.affiliation: Inova Fairfax Hospital, Falls Church, VA.
authors.forename: Fran
authors.initials: F
authors.lastname: Vasaly
authors.affiliation: Inova Fairfax Hospital, Falls Church, VA.
authors.forename: Jean
authors.initials: J
authors.lastname: Donovan
authors.affiliation: Inova Fairfax Hospital, Falls Church, VA.
authors.forename: John
authors.initials: J
authors.lastname: Moynihan
authors.affiliation: Inova Fairfax Hospital, Falls Church, VA HDavid.Reines@inova.org.
authors.forename: H David
authors.initials: HD
authors.lastname: Reines
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D055499:Catheter-Related Infections / Q000209:etiology; D003428:Cross Infection / Q000209:etiology*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D058996:Quality Improvement / Q000706:statistics & numerical data*; D012307:Risk Factors; D012737:Sex Factors; D013514:Surgical Procedures, Operative / Q000009:adverse effects / Q000592:standards; D014546:Urinary Catheterization / Q000009:adverse effects / Q000592:standards; D014552:Urinary Tract Infections / Q000209:etiology*
keywords: NSQIP; SCIP; urinary catheters; urinary tract infections