Rebecca Grant1, Martine Aupee2, Nicolas C Buchs3, Kristine Cooper4, Marie-Christine Eisenring5, Theresa Lamagni4, Frédéric Ris3, Juliette Tanguy2, Nicolas Troillet5, Stephan Harbarth1, Mohamed Abbas1. 1. Infection Control Programme,University of Geneva Hospitals and Faculty of Medicine,Geneva,Switzerland. 2. Coordination Center for Prevention and Control of Nosocomial Infections (CClin) Ouest,Rennes,France. 3. Service of Visceral Surgery, Department of Surgery,University of Geneva Hospitals and Faculty of Medicine,Geneva,Switzerland. 4. National Infection Service,Public Health England, London,United Kingdom. 5. Swissnoso,National Center for Infection Prevention,Bern,Switzerland.
Abstract
OBJECTIVE: To assess the validity of multivariable models for predicting risk of surgical site infection (SSI) after colorectal surgery based on routinely collected data in national surveillance networks. DESIGN: Retrospective analysis performed on 3 validation cohorts. PATIENTS: Colorectal surgery patients in Switzerland, France, and England, 2007-2017. METHODS: We determined calibration and discrimination (ie, area under the curve, AUC) of the COLA (contamination class, obesity, laparoscopy, American Society of Anesthesiologists [ASA]) multivariable risk model and the National Healthcare Safety Network (NHSN) multivariable risk model in each cohort. A new score was constructed based on multivariable analysis of the Swiss cohort following colorectal surgery, then based on colon and rectal surgery separately. RESULTS: We included 40,813 patients who had undergone elective or emergency colorectal surgery to validate the COLA score, 45,216 patients to validate the NHSN colon and rectal surgery risk models, and 46,320 patients in the construction of a new predictive model. The COLA score's predictive ability was poor, with AUC values of 0.64 (95% confidence interval [CI], 0.63-0.65), 0.62 (95% CI, 0.58-0.67), 0.60 (95% CI, 0.58-0.61) in the Swiss, French, and English cohorts, respectively. The NHSN colon-specific model (AUC, 0.61; 95% CI, 0.61-0.62) and the rectal surgery-specific model (AUC, 0.57; 95% CI, 0.53-0.61) showed limited predictive ability. The new predictive score showed poor predictive accuracy for colorectal surgery overall (AUC, 0.65; 95% CI, 0.64-0.66), for colon surgery (AUC, 0.65; 95% CI, 0.65-0.66), and for rectal surgery (AUC, 0.63; 95% CI, 0.60-0.66). CONCLUSION: Models based on routinely collected data in SSI surveillance networks poorly predict individual risk of SSI following colorectal surgery. Further models that include other more predictive variables could be developed and validated.
OBJECTIVE: To assess the validity of multivariable models for predicting risk of surgical site infection (SSI) after colorectal surgery based on routinely collected data in national surveillance networks. DESIGN: Retrospective analysis performed on 3 validation cohorts. PATIENTS: Colorectal surgery patients in Switzerland, France, and England, 2007-2017. METHODS: We determined calibration and discrimination (ie, area under the curve, AUC) of the COLA (contamination class, obesity, laparoscopy, American Society of Anesthesiologists [ASA]) multivariable risk model and the National Healthcare Safety Network (NHSN) multivariable risk model in each cohort. A new score was constructed based on multivariable analysis of the Swiss cohort following colorectal surgery, then based on colon and rectal surgery separately. RESULTS: We included 40,813 patients who had undergone elective or emergency colorectal surgery to validate the COLA score, 45,216 patients to validate the NHSN colon and rectal surgery risk models, and 46,320 patients in the construction of a new predictive model. The COLA score's predictive ability was poor, with AUC values of 0.64 (95% confidence interval [CI], 0.63-0.65), 0.62 (95% CI, 0.58-0.67), 0.60 (95% CI, 0.58-0.61) in the Swiss, French, and English cohorts, respectively. The NHSN colon-specific model (AUC, 0.61; 95% CI, 0.61-0.62) and the rectal surgery-specific model (AUC, 0.57; 95% CI, 0.53-0.61) showed limited predictive ability. The new predictive score showed poor predictive accuracy for colorectal surgery overall (AUC, 0.65; 95% CI, 0.64-0.66), for colon surgery (AUC, 0.65; 95% CI, 0.65-0.66), and for rectal surgery (AUC, 0.63; 95% CI, 0.60-0.66). CONCLUSION: Models based on routinely collected data in SSI surveillance networks poorly predict individual risk of SSI following colorectal surgery. Further models that include other more predictive variables could be developed and validated.
Authors: Mohamed Abbas; Nadia Gaïa; Nicolas C Buchs; Vaihere Delaune; Myriam Girard; Diego O Andrey; Jeremy Meyer; Jacques Schrenzel; Frédéric Ris; Stephan Harbarth; Vladimir Lazarevic Journal: Gut Pathog Date: 2022-01-04 Impact factor: 4.181
Authors: Janneke D M Verberk; Stephanie M van Rooden; David J Hetem; Herman F Wunderink; Anne L M Vlek; Corianne Meijer; Eva A H van Ravensbergen; Elisabeth G W Huijskens; Saara J Vainio; Marc J M Bonten; Maaike S M van Mourik Journal: Antimicrob Resist Infect Control Date: 2022-01-21 Impact factor: 4.887