How infection present at time of surgery (PATOS) data impacts your surgical site infection (SSI) standardized infection ratios (SIR), with focus on the complex 30-day SSI SIR model.
How infection present at time of surgery (PATOS) data impacts your surgical site infection (SSI) standardized infection ratios (SIR), with focus on the complex 30-day SSI SIR model.
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DOI：
10.1016/j.ajic.2021.05.002
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发表时间：
2021-11
影响因子：
4.9
通讯作者：
中科院分区：
文献类型：
--
作者：
本案例研究是以疾病控制与预防中心的国家医疗安全网络 (NHSN) 医疗相关感染 (HAI) 监测定义为中心的系列研究的一部分。这是自 2015 年 CDC/NHSN 更新其 HAI 风险调整模型并重新设定标准化感染率 (SIR) 基线以来，在 AJIC 上发表的第一个分析案例研究。该案例描述了感染预防专家 (IP) 在分析手术部位感染 (SSI) 监测数据时遇到的情况。该案例研究旨在通过强调 NHSN 旧版和新版风险模型标准的差异（原始版本和 2015 年引入的更新模型）来说明特定模型如何影响 SIR 结果。了解这些差异可以深入了解 SSI SIR 计算在旧版和新版 NHSN 基线模型之间的差异。 NHSN 计划在未来使用更新的 HAI 发生率和风险因素数据制作另一套 HAI 风险调整模型。虽然这些变化的时间表仍有待确定，但用于生成未来模型和 SIR 计算的统计方法将延续 NHSN 已建立的先例。提供在线调查链接，参与者可以秘密回答与案例研究相关的问题，并以正确答案、解释、理由和教学要点总结的形式收到即时反馈。案例研究的详细信息、答案和解释已经过 NHSN 工作人员的审查和批准。我们希望参与者能够利用这一教育产品，从而更好地了解 NHSN 的 HAI 数据分析。国家医疗安全网络 (NHSN) 中有 2 个可用于 SSI 标准化感染率 (SIR) 的基线；一份基于 2006-2008 年全国汇总数据，另一份基于 2015 年数据。 2 个基线中的每一个都有一组不同的 SSI 数据纳入标准，这会影响 SIR 的计算。在本案例研究中，我们重点关注在 2006-2008 年基线 SSI SIR 计算中包含 PATOS 以及在 2015 年基线 SSI SIR 计算中排除 PATOS 的影响。在 2006-2008 年基线 SSI SIR 中，PATOS 事件及其关联的程序包含在 SSI SIR 的计算中，而在 2015 年基线 SSI SIR 中，PATOS 事件及其关联的程序不包括在 SSI SIR 的计算中。这意味着，如果我们控制两个基线的 PATOS 数据之外的所有其他纳入标准，我们将注意到两个基线的观察到事件数量以及预测感染数量的差异。有关 2015 年基线和风险调整计算的详细信息，请查看下面引用的 NHSN SIR 指南。 2006-2008年基线4和风险调整的详细信息，请参见作者易穆发表的SHEA论文“Improving Risk-Adjusted Measures of Surgical Site Infection for the National Healthcare Safety Network”。
This case study is part of a series centered on the Centers for Disease Control and Prevention’s National Healthcare Safety Network’s (NHSN) health care-associated infection (HAI) surveillance definitions. This is the first analytic case study published in AJIC since the CDC/ NHSN updated its HAI risk adjustment models and rebaselined the standardized infection ratios (SIRs) in 2015. This case describes a scenario that Infection Preventionists (IPs) have encountered during their analysis of surgical site infection (SSI) surveillance data. The case study is intended to illustrate how specific models can impact the SIR results by highlighting differences in the criteria for NHSN’s older and newer risk models: the original versions and the updated models introduced in 2015. Understanding these differences provides insight into how SSI SIR calculations differ between the older and newer NHSN baseline models. NHSN plans to produce another set of HAI risk adjustment models in the future, using newer HAI incidence and risk factor data. While the timetable for these changes remains to be determined, the statistical methods used to produce future models and SIR calculations will continue the precedents that NHSN has established. An online survey link is provided where participants may confidentially answer questions related to the case study and receive immediate feedback in the form of correct answers, explanations, rationales, and summary of teaching points. Details of the case study, answers, and explanations have been reviewed and approved by NHSN staff. We hope that participants take advantage of this educational offering and thereby gain a greater understanding of the NHSN’s HAI data analysis. There are 2 baselines available for SSI standardized infection ration (SIRs) in the National Healthcare Safety Network (NHSN); one based on the 2006-2008 national aggregate data and another based on the 2015 data. Each of the 2 baselines has a different set of inclusion criteria for the SSI data, which impact the calculation of the SIR. In this case study, we focused on the impact of the inclusion of PATOS in the calculation of the 2006-2008 baseline SSI SIR and the exclusion of PATOS from the calculation of the 2015 baseline SSI SIR. In the 2006-2008 baseline SSI SIRs, PATOS events and the procedures to which they are linked are included in the calculation of the SSI SIR whereas in the 2015 baseline SSI SIRs, PATOS events and the procedures to which they are linked are excluded from the calculation of the SSI SIR. Meaning, if we control for all other inclusion criteria other than PATOS data for both baselines, we will notice differences in the number of observed events as well as the number of predicted infections for the 2 baselines. For details of the 2015 baseline and risk adjustment calculation, please review the NHSN Guide to the SIR referenced below. For details of the 2006-2008 baseline4 and risk adjustment, please see the SHEA paper “Improving Risk-Adjusted Measures of Surgical Site Infection for the National Healthcare Safety Network” by author Yi Mu.
影响因子：
4.9
作者：
Wright, Marc-Oliver;Hebden, Joan N.;Horan, Teresa
通讯作者：
Horan, Teresa