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Evaluation of the SENIC Risk Index in a Spanish University Hospital

Published online by Cambridge University Press:  02 January 2015

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

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
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1999

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