Appendix K. Final Risk Factors

Risk FactorImportantFeasibleFeasible, Difficult
(e.g. Chart Review)
Age660
Gender350
Body Mass Index641
Comorbidity Score (Charlson or whatever is available) 521
Diabetes631
Chronic Lung Disease321
Chronic Kidney Disease321
Peripheral vascular disease211
Prior site irradiation (At any time) 312
Recent operation (Within 30 days) 540
Skin carriage of staphylococci311
Skin disease in the area of surgery (eg, psoriasis)201
Wound Class651
Emergent Procedure550
ASA Score550
Revision/Re-do Operation440
Pre-Op Hospitalization (# of days) 550
Hx of MRSA321
Homelessness100
Hospitalizations in Prior 12 Months (#) 000
Surgical Site350
Insurance/Payor Source010
Hx Rheumatologic Disease120
Previous Surgical Site Infection541
Instututionalized220
NNIS Risk Index411
Glucose Control (Hgb A1C and Pre-op Glucose) 650
Hypocholesterolemia010
Preoperative anemia660
Postoperative anemia340
Remote infection431
Malnutrition (Wt loss, albumin, prealbumin) 641
Smoking660
Alcohol Abuse450
Substance Abuse120
Staph Aureus Colonization320
Preoperative Shower430
Immunosuppressive Drugs Pre-Op550
Pre-Op Albumin Level650
Ascites521
Chronic inflammation211
Corticosteroid therapy  w/in 30 Days430
Duration of Surgery (min)650
Tourniquet Time220
Post-Op Mechanical Ventilation220
Surgeon Experience (# Past 12 Months)320
Surgeon Age000
Laparoscopic Approach550
General Anesthesia120
No. of Personnel in OR320
Trainee (Lowest Level) Scrubbed in OR220
OR Traffic110
Timely Pre-Op Abx660
Appropriate Pre-op Abx660
Discontinuation of Post-Op Abx <24 hr440
Appropriate Intra-Op Re-dosing of Abx550
Lowest Intra-Op Temperature550
Temperature on Arrival to PACU550
Peri-Op Glucose <100000
Peri-Op Glucose <200641
Peri-Op Transfusion541
Skin Prep550
Hair Removal550
Abx Irrigation120
Injections into Wound (e.g., Local Anesthetic)010
Implant330
Anesthetic Drugs000
Outpatient Surgery220
Inpatient Surgery220
Post-Op Admit110
Laminar Airflow OR110
HEPA Filtered OR110
Number of Procedures (in same OR session) 110
Use of Drain650
ICU Admission Post-Op110
Perioperative Hyperoxia (FiO2 80%)330
Peri-Op Insulin Administration220
Peri-Op Proton Pump Inhibitor110
Peri-Op VTE Prophylaxis220
Post-Op Wound Care by Nurse220
Anticoagulation Medication220
Post-Op Ambulation (What Day?) 110
Liters of IV Fluid in OR440
Liters of Fluid 24 hrs Post-Op220
Central Line230
Pre-Op Hemoglobobin550
Use of Stryker Suit010
Surgeon Beard010
Tissue expander use000
Daily living assistance needed210
Excessive blood loss; > 1 liter430
Suture material (Deep, and in wound) 430
Incision method110
Frequency of glove change100
Subcutaneous hematoma420
Hx of cancer220
Periop allogeneic blood transfusion330
Interop vasopressor330
preop mechanical ventilation110
Hx of abx allergy120
Preop urinary catheterization230
Skin closure method330
Periop lapse in discipline?311
Transfer from another hospital010
Tumor necrosis factor blockers010
Development of DVT010
Intraop inspired O2 < 50%120
Duration of hypothermia; < 35.5411
Tracheotomy010
Bowel or bladder dysfunction001
No. of surgeons scrubbed120
Hx of COPD120
Page last reviewed December 2012
Internet Citation: Appendix K. Final Risk Factors. December 2012. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/final-reports/ssi/ssiapk.html