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Table 1 Definitions of perioperative infections

From: American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on prevention of postoperative infection within an enhanced recovery pathway for elective colorectal surgery

Type Rate infections, n = 432,756 colorectal proceduresa (%) Median (interquartile range) days from operation to infectious complication NSQIP definitionsb Criteria
Any infectious complication 15.1 Composite variable of the below. N/A
Superficial SSI 5.3 9 (6–14) Infection involving only skin or subcutaneous tissue of the incision. Requires symptoms (pain, erythema, swelling, heat) and presence of pus or a positive culture or intentional opening of the wound.
Deep incisional SSI 1.3 10 (6–16) Infection involving deep soft tissues. Deep soft tissues are typically any tissue beneath the skin and immediate subcutaneous fat, for example, fascial and muscle layers. Pus must not be from organ space or deep incision spontaneously dehisces or is deliberately opened by a surgeon when the patient has at least one of the following signs or symptoms: fever (>38 °C), localized pain, or tenderness, unless the site is culture-negative direct examination, during reoperation, or by histo-pathologic or radiologic examination radiographic evidence of abscess.
Organ/space SSI 6.4 10 (7–16) Infection involving any part of the anatomy (e.g., organs or spaces), other than the incision, which was opened or manipulated during an operation. Pus from a drain that is placed through a stab wound into the organ/space. Organisms isolated from an aseptically obtained culture of fluid or tissue in the organ/space. An abscess or other evidence of infection involving the organ/space that is found on direct examination, during reoperation, or by histo-pathologic or radiologic examination.
Pneumonia 2.5 5 (3–10) An infection of one or both lungs caused by bacteria, viruses, fungi, or aspiration. Pneumonia can be community acquired or acquired in a healthcare setting. Requires CXR or CT chest evidence of infiltrate, consolidation, opacity, or cavitation as well as 2 signs, symptoms, or lab values.
UTI 2.6 9 (5–16) Infection in the urinary tract (kidneys, ureters, bladder, and urethra). Requires 1 of the following 6 criteria: fever (>38 °C or 100.4 °F), urgency, frequency, dysuria, suprapubic tenderness, costovertebral angle pain or tenderness and a positive urine culture OR 2 of the above criteria and 2 urine cultures or empiric treatment for presumptive UTI.
Sepsis 3.7 7 (3–13)   
Septic shock 2.2 4 (1–9)   
CLABSI Not presently included in NSQIP.  
  1. Definitions are available from the 2015 NSQIP Participant User File User Guide: https://www.facs.org/~/media/files/quality%20programs/nsqip/nsqip_puf_user_guide_2015.ashx
  2. aPreviously unpublished, courtesy of Dr. Holubar, NSQIP 2005–2014, CPT ranges 44xxx–46999
  3. bLimited to first 30 days. All definitions may be superseded by surgeon documentation of the infection in the medical record