title: A prospective study on surgical-site infections in thyroid operation.
abstract: BACKGROUND
  To evaluate the incidence and the microbe spectrum of surgical-site infections (SSIs) in patients undergoing elective thyroid operation and to develop a risk factor-based predictive model.
  
  
  METHODS
  This prospective study included 6,778 consecutive patients who underwent thyroid operation at a single institution between 2007 and 2012. SSI was defined according to the Centers for Disease Control and Prevention. Regression models were fitted to evaluate risk factors for SSI. A predictive nomogram was constructed from relevant variables in the multivariable analysis. Discrimination and calibration of the nomogram were assessed.
  
  
  RESULTS
  The cumulative incidence of SSI after 30 days was 0.49%. The median time from operation to SSI was 7 days (interquartile range, 4-10.5 days). SSI was classified as superficial incisional in 30 cases (93.8%), deep incisional in 1 case (3.1%), and organ/space in 1 case (3.1%). Staphylococcus aureus was the most common isolate. In multivariable analysis, duration of operation (P = .004) and American Society of Anesthesiologists' score (P = .031) were identified as independent risk factors for SSI. These variables formed the basis of a nomogram, which was validated internally by bootstrapping and reached a predictive accuracy of 70.1%. The calibration curve showed a good agreement between predicted probability and actual observation.
  
  
  CONCLUSIONS
  The cumulative incidence of SSI in thyroid operation is <0.5%. American Society of Anesthesiologists' score and the duration of operation are independent risk factors for SSI. Antibiotic prophylaxis may be considered for selected patients based on the individual risk profile.
authors: Second Department of Surgery, Krankenanstalt Rudolfstiftung, Vienna, Austria; Department of Surgery, Kaiserin-Elisabeth-Spital, Vienna, Austria.
authors: Claudia
authors: C
authors: Bures
authors: Second Department of Surgery, Krankenanstalt Rudolfstiftung, Vienna, Austria; Department of Urology, Medical University of Vienna, Vienna, Austria. Electronic address: tobias.klatte@gmx.de.
authors: Tobias
authors: T
authors: Klatte
authors: Department of Pathology and Microbiology with Hospital Hygiene Team, Kaiserin-Elisabeth-Spital, Vienna, Austria; Department of Pathology and Microbiology, Krankenanstalt Rudolfstiftung, Vienna, Austria.
authors: Monika
authors: M
authors: Gilhofer
authors: Nationales Referenzzentrum für Surveillance von nosokomialen Infektionen, Charité-Universitätsmedizin, Berlin, Germany.
authors: Michael
authors: M
authors: Behnke
authors: Nationales Referenzzentrum für Surveillance von nosokomialen Infektionen, Charité-Universitätsmedizin, Berlin, Germany.
authors: Ann-Christin
authors: AC
authors: Breier
authors: Department of Pathology and Microbiology with Hospital Hygiene Team, Kaiserin-Elisabeth-Spital, Vienna, Austria.
authors: Nikolaus
authors: N
authors: Neuhold
authors: Second Department of Surgery, Krankenanstalt Rudolfstiftung, Vienna, Austria; Department of Surgery, Kaiserin-Elisabeth-Spital, Vienna, Austria.
authors: Michael
authors: M
authors: Hermann
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D019468:Disease Management; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D049451:Nomograms; D061646:Operative Time; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology* / Q000517:prevention & control; D013961:Thyroid Gland / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects*
chemical_list: D000900:Anti-Bacterial Agents