Table 1 Definitions of perioperative infections
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. |  |