title: Identification of Risk Factors for Acute Surgical Site Infections in Musculoskeletal Tumor Patients Using CDC/NHSN Criteria.
abstract: BACKGROUND
  Acute surgical site infections (SSI) are well-recognized postoperative complications, representing a significant source of patient morbidity and cost to the healthcare system. This study is among the first to use standardized criteria for the diagnosis of acute SSI in orthopaedic oncology.
  
  
  METHODS
  The medical records of 165 patients were retrospectively reviewed for the occurrence of superficial or deep SSI as defined by the Center for Disease Control's National Healthcare Safety Network (CDC/NHSN) criteria. Patient, disease, and procedure-specific variables were evaluated as potential risk factors for infection.
  
  
  RESULTS
  The overall rate of acute SSI was 10.3%. Univariate analysis demonstrated the significance of malignant pathology (p < 0.001), ASA classification (p = 0.009), operative duration (p < 0.001), intraoperative RBC transfusions (p = 0.03), the performance of an amputation (p = 0.016), and race (p = 0.008) on the incidence of SSI. Prolonged operative duration (p = 0.014) and race (p = 0.005) were found to be independent risk factors with odds ratios of 1.89 (95%, CI: 1.14 to 3.14) and 0.047 (95%, CI: 0.006 to 0.387), respectively.
  
  
  CONCLUSIONS
  By using the CDC/NHSN guidelines for the diagnosis of acute SSI, we identified prolonged operative time and non-Caucasian race as independent risk factors for infection in musculoskeletal tumor patients.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Lerman
authors.forename: Alan T
authors.initials: AT
authors.lastname: Blank
authors.forename: Jessica I
authors.initials: JI
authors.lastname: Billig
authors.forename: Raj
authors.initials: R
authors.lastname: Karia
authors.forename: Timothy B
authors.initials: TB
authors.lastname: Rapp
mesh_terms: D000208:Acute Disease; D000328:Adult; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008499:Medical Records; D015999:Multivariate Analysis; D009140:Musculoskeletal Diseases / Q000208:ethnology / Q000473:pathology / Q000601:surgery*; D009369:Neoplasms / Q000208:ethnology / Q000473:pathology / Q000601:surgery*; D009519:New York City / Q000453:epidemiology; D016017:Odds Ratio; D061646:Operative Time; D011237:Predictive Value of Tests; D044469:Racial Groups; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000208:ethnology / Q000209:etiology* / Q000382:microbiology