title: Incidence and risk factors for and the effect of a program to reduce the incidence of surgical site infection after cardiac surgery.
abstract: BACKGROUND
  Surgical site infection (SSI) after cardiac surgery (CS) is a serious complication that increases hospital length of stay (LOS), has a substantial financial impact, and increases mortality. The study described here was done to evaluate the effect of a program to reduce SSI after CS.
  
  
  METHODS
  In January 2007, a multi-disciplinary CS infection-prevention team developed guidelines and implemented bundled tactics for reducing SSI. Data for all patients who underwent CS from 2006-2008 were used to determine whether there was: 1) A difference in the incidence of SSI in white patients and those belonging to minority groups; 2) a reduction in SSI after intervention; and 3) a statistically significant difference in the incidence of SSI in the third quarter of each year as compared with the other quarters of the year.
  
  
  RESULTS
  Of 3,418 patients who underwent CS; 1,125 (32.9%) were members of minority groups and 2,293 (67.1%) were white. Eighty (2.3%) patients developed SSI. There was no significant difference in the incidence of SSI in non-Hispanic white patients and all others (2.1% vs. 2.8%, p=0. 42). The incidence of SSI decreased significantly from 2006 (3.0%) to 2007 (2.5%) and 2008 (1.4%), (p=0.03). Surgical site infection occurred more often in the third quarter of each of the years of the study than in other quarters of each year (3.3 vs. 2.0%, p=0.038).
  
  
  CONCLUSIONS
  Implementation of a program to reduce SSI after CS was associated with a lower incidence of SSI across all racial and ethnic groups and over time, but was not associated with a lower incidence of SSI in the third quarter of each year than in the other quarters.
authors.affiliation: 1 Department of Surgery, Columbia University College of Physicians and Surgeons , New York, New York.
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Hogle
authors.forename: Bevin
authors.initials: B
authors.lastname: Cohen
authors.forename: Sandra
authors.initials: S
authors.lastname: Hyman
authors.forename: Elaine
authors.initials: E
authors.lastname: Larson
authors.forename: Dennis L
authors.initials: DL
authors.lastname: Fowler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000517:prevention & control*; D013903:Thoracic Surgery