Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-15T01:57:35.732Z Has data issue: false hasContentIssue false
  • English
  • Français

Evaluation of the SENIC Risk Index in a Spanish University Hospital

Published online by Cambridge University Press:  02 January 2015

Victoria Valls ,
Manuel Díez ,
Javier Ena ,
Alberto Gutiérrez ,
Peña Gómez-Herruz ,
Antonio Martín ,
Rosario Gónzalez-Palacios  and
Javier Granell
Victoria Valls*
Affiliation:
Department of Preventive Medicine, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain Servicio de Medicina Preventiva, Hospital Marina Baixa, 03570 Villajoyosa, Alicante, Spain
Manuel Díez
Affiliation:
Department of General Surgery, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
Javier Ena
Affiliation:
Department of Internal Medicine, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain Servicio de Medicina Interna, Hospital Marina Baixa, 03570 Villajoyosa, Alicante, Spain
Alberto Gutiérrez
Affiliation:
Department of General Surgery, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
Peña Gómez-Herruz
Affiliation:
Department of Clinical Microbiology, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
Antonio Martín
Affiliation:
Department of General Surgery, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
Rosario Gónzalez-Palacios
Affiliation:
Department of Clinical Microbiology, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
*
Urb Jardín del Mar Mediterráneo, Camí Fondo 2, ESC 17 5C, El Campello, 03560-Alicante, Spain
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To assess the performance of the Study of the Efficacy of Nosocomial Infection Control (SENIC) risk index for the evaluation of the risk of surgical-site infection (SSI) in a country other than the United States, having a different health system.

Setting:

350-bed university hospital in Spain belonging to the National Health System (Insalud).

Design:

Observational cohort study of 1,019 patients who underwent consecutive surgery from January to December 1992. Surgical-infection risk factors assessed by the traditional wound-classification system (clean, clean-contaminated, contaminated, and dirty-infected wound) and by the SENIC risk index (length of intervention more than 2 hours, more than three discharge diagnoses, abdominal surgery, and contaminated or dirty-infected wound) were compared by forward logistic regression.

Results:

The SENIC risk index showed a greater ability to predict SSI than the traditional wound-classification system. The study carried out in our institution reproduced the estimators provided by the SENIC study in the United States. The SENIC risk index provided a stepwise increase in SSI rates, according to the number of factors present, for every traditional wound-classification group. In the case of clean wounds, the incidence of surgical infection (per 100 interventions) increased (1.5, 2.4, 5.3, and 50; P<.001) for patients having from zero to three risk factors of the SENIC risk index.

Conclusions:

This study shows that the SENIC risk index results are reproducible, and the index can be used to compare rates of wound infection across countries with different health systems than the United States.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 20 , Issue 3 , March 1999 , pp. 196 - 199
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1999

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Altemeier, WA, Burke, JF, Pruitt, BA, Sandusky, WR, eds. Manual on Control of Infection in Surgical Patients. Philadelphia, PA: Lippincott Co; 1984.Google Scholar
2. National Academy of Sciences-National Research Council. Postoperative wound infections: the influence of ultraviolet irradiation of the operating room and of various other factors. Ann Surg 1964;160(suppl 2):1–132.Google Scholar
3. Gordon, SM, Culver, DH, Simmons, BP, Jarvis, WR. Risk factors for wound infections after total knee arthroplasty. Am J Epidemiol 1990;131: 905–916.Google Scholar
4. Nicolle, LE, Huchcroft, SA, Cruse, PJE. Risk factors for surgical wound infection among the elderly. J Clin Epidemiol 1992;45:357–364.CrossRefGoogle ScholarPubMed
5. Haley, RW, Culver, DH, Morgan, WM, White, JW, Emori, TG, Hooton, TM. Identifying patients at high risk of surgical wound infection: a simple multivariate index of patient susceptibility and wound contamination. Am J Epidemiol 1985;121:206–215.Google Scholar
6. Garner, JS, Jarvis, WR, Emori, TG, Horan, TC, Hughes, JM. CDC definitions for nosocomial infections, 1988. Am J Infect Control 1988;16: 128–140.Google Scholar
7. The Society for Hospital Epidemiology of America, the Association for Practitioners in Infection Control, the Centers for Disease Control and Prevention, the Surgical Infection Society. Consensus paper on the surveillance of surgical wound infections. Infect Control Hosp Epidemiol 1992;13:599–605.Google Scholar
8. Kleimbaum, DG, Kupper, LL, Morganstern, H, eds. Epidemiologic Research. Principles and Quantitative Methods. New York, NY: Van Nostrand Reinhold; 1982.Google Scholar
9. Goodman, LA, Kruskal, WH. Measures for of association for cross classifications. Journal of the American Statistical Association 1954;49:732–764.Google Scholar
10. Culver, DH, Horan, TC, Gaynes, RP, Martone, WJ, Jarvis, WR, Emori, TG, et al. Surgical wound infection rates by wound class, operative procedure and patients risk index. Am J Med 1991;91(3B):152S–157S.Google Scholar
11. Owens, WD, Felts, JA, Spitznagel, EL. ASA physical status classifications: a study of consistency of ratings. Anesthesiology 1978;49:239–243.Google Scholar
12. Keats, AR. The ASA classification of the physical status—a recapitulation. Anesthesiology 1978;49:233–236.Google Scholar
13. Hooton, TM, Haley, RW, Culver, DH, White, JW, Morgan, WM, Carroll, RJ. The joint association of multiple risk factors with the occurrence of nosocomial infection. Am J Med 1981;70:960–970.Google Scholar
14. Christou, NV, Nohr, CS, Meakins, JL. Assessing operative site infection in surgical patients. Arch Surg 1987;122:165–169.CrossRefGoogle ScholarPubMed
15. Haley, RW. Nosocomial infections in surgical patients: developing valid measures of intrinsic patient risk. Am J Med 1991;91(suppl 3B): 145S–151S.Google Scholar
16. Redelmeier, DA, Fuchs, VR. Hospital expenditures in the United States and Canada. N Engl J Med 1993;328:772–778.Google Scholar