title: What Is the Real Rate of Surgical Site Infection?
abstract: Surgical site infections (SSIs) are associated with patient morbidity and increased health care costs. Although several national organizations including the University HealthSystem Consortium (UHC), the National Surgical Quality Improvement Program (NSQIP), and the National Healthcare Safety Network (NHSN) monitor SSI, there is no standard reporting methodology.
  
  
  
  We queried the UHC, NSQIP, and NHSN databases from July 2012 to June 2014 for SSI after gynecologic surgery at our institution. Each organization uses different definitions and inclusion and exclusion criteria for SSI. The rate of SSI was also obtained from chart review from April 1 to June 30, 2014. SSI was classified as superficial, deep, or organ space infection. The rates reported by the agencies were compared with the rates obtained by chart review using Fisher's exact test.
  
  
  
  Overall SSI rates for the databases were as follows: UHC, 1.5%; NSQIP, 8.8%; and NHSN, 2.8% (P < .001). The individual databases had wide variation in the rate of deep infection (UHC, 0.7%; NSQIP, 4.7%; NHSN, 1.3%; P < .001) and organ space infection (UHC, 0.4%; NSQIP, 4.4%; NHSN, 1.4%; P < .001). In agreement with the variation in reporting methodology, only 19 cases (24.4%) were included in more than one database and only one case was included in all three databases (1.3%).
  
  
  
  There is discordance among national reporting agencies tracking SSI. Adopting standardized metrics across agencies could improve consistency and accuracy in assessing SSI rates.
authors.affiliation: The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Jolyn S
authors.initials: JS
authors.lastname: Taylor
authors.affiliation: The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Claire A
authors.initials: CA
authors.lastname: Marten
authors.affiliation: The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Potts
authors.affiliation: The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Lynn M
authors.initials: LM
authors.lastname: Cloutier
authors.affiliation: The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Cain
authors.affiliation: The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Shauna L
authors.initials: SL
authors.lastname: Fenton
authors.affiliation: The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Tara N
authors.initials: TN
authors.lastname: Tatum
authors.affiliation: The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Deepthi A
authors.initials: DA
authors.lastname: James
authors.affiliation: The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Keith N
authors.initials: KN
authors.lastname: Myers
authors.affiliation: The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Cheryl A
authors.initials: CA
authors.lastname: Hubbs
authors.affiliation: The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Jennifer K
authors.initials: JK
authors.lastname: Burzawa
authors.affiliation: The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Shital
authors.initials: S
authors.lastname: Vachhani
authors.affiliation: The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Alpa M
authors.initials: AM
authors.lastname: Nick
authors.affiliation: The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Larissa A
authors.initials: LA
authors.lastname: Meyer
authors.affiliation: The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Linda S
authors.initials: LS
authors.lastname: Graviss
authors.affiliation: The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Kathy M
authors.initials: KM
authors.lastname: Ware
authors.affiliation: The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Anne K
authors.initials: AK
authors.lastname: Park
authors.affiliation: The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Aloia
authors.affiliation: The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Diane C
authors.initials: DC
authors.lastname: Bodurka
authors.affiliation: The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Charles F
authors.initials: CF
authors.lastname: Levenback
authors.affiliation: The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Schmeler
mesh_terms: D016208:Databases, Factual; D006077:Government Agencies; D006801:Humans; D011787:Quality of Health Care; D013530:Surgical Wound Infection / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology