Appendix I. Initial Risk Factors

Risk FactorEvidenceModifiable?PatientPerioperativeSurgeon
Age NY  
Gender NY  
Body Mass IndexIINY  
Comorbidity Score NY  
DiabetesIINY  
Chronic Lung Disease NY  
Chronic Kidney Disease NY  
Peripheral vascular disease NY  
Prior site irradiation NY  
Recent operation NY  
Skin carriage of staphylococci NY  
Skin disease in the area of infection (eg, psoriasis) NY  
Wound ClassINY  
Emergent Procedure NY  
ASA ScoreINY  
Revision/Re-do Operation NY  
Pre-Op Hospitalization NY  
Hx of MRSA NY  
Post-Op Wound Care by Nurse Y Y 
Hospitalizations in Prior 12 Months NY  
Surgical Site NY  
Anesthetic Drugs Y Y 
Hx Rheumatologic Disease NY  
Previous Surgical Site Infection NY  
Instututionalized NY  
NNIS Risk IndexINY  
Glucose Control YY  
Hypocholesterolemia YY  
Preoperative anemia YY  
Postoperative anemia YY  
Remote infection YY  
Malnutrition YY  
Smoking YY  
Outpatient Surgery Y Y 
Inpatient Surgery Y Y 
Staph Aureus Colonization YY  
Preoperative Shower YY  
Immunosuppressive Drugs Pre-Op YY  
Pre-Op Albumin Level  Y  
Ascites  Y  
Chronic inflammation  Y  
Corticosteroid therapy  w/in 30 Days  Y  
Duration of Surgery (min) N Y 
Tourniquet Time N Y 
Post-Op Mechanical Ventilation N Y 
Laminar Airflow OR Y Y 
HEPA Filtered OR Y Y 
Laparoscopic ApproachIY Y 
General Anesthesia Y Y 
Post-Op Admit Y Y 
ICU Admission Post-Op Y Y 
Perioperative Hyperoxia (FiO2 80%) Y Y 
Timely Pre-Op AbxIY Y 
Appropriate Pre-op AbxIIY Y 
Discontinuation of Post-Op Abx <24 hrIIIY Y 
Appropriate Intra-Op Re-dosing of Abx Y Y 
Lowest Intra-Op TemperatureIY Y 
Temperature on Arrival to PACUIY Y 
Peri-Op Glucose <100 Y Y 
Peri-Op Glucose <200 Y Y 
Peri-Op TransfusionIIY Y 
Skin PrepIY Y 
Hair RemovalIIY Y 
Abx Irrigation Y Y 
Injections into Wound (e.g., Local Anesthetic) Y Y 
Implant Y Y 
Tissue expander useD    
Daily living assistance neededM    
Excessive blood loss; > 1 literM    
Suture material (Deep, and in wound) D    
Incision methodM    
Frequency of glove changeU    
Subcutaneous hematomaD if ICD9 or M    
Hx of cancerD    
Periop allogeneic blood transfusionM for periop    
Interop vasopressorD    
preop mechanical ventilationLL    
Hx of abx allergyLL    
Preop urinary catheterizationLL    
Skin closure methodM    
Periop lapse in discipline???    
Transfer from another hospitalD    
Tumor necrosis factor blockersD    
Development of DVTD    
Intraop inspired O2 < 50%M    
Duration of hypothermia; < 35.5D for approx. time    
TracheotomyD    
Bowel or bladder dysfunctionD    
No. of surgeons scrubbedD    
Hx of COPDD    
Current as of December 2012
Internet Citation: Appendix I. Initial Risk Factors. December 2012. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/final-reports/ssi/ssiapi.html