Accuracy of selective postoperative surgical site infection surveillance among high-risk patients compared with traditional surveillance in a tertiary university hospital.
- Author:
Domingo S. Bongala, Jr.
1
Author Information
- Publication Type:Journal Article
- Keywords: Surgical site infection (SSI); SSI surveillance; Risk stratification; High-risk surgical patients; Healthcare-associated infections; Infection prevention
- MeSH: Surgical Wound Infection; Cross Infection;
- From: Health Sciences Journal 2026;15(1):1-9
- CountryPhilippines
- Language:English
-
Abstract:
Introduction:Surgical site infection (SSI) surveillance is resource-intensive, particularly in low-resource settings. This study evaluated whether selective surveillance of high-risk patients can accurately identify
postoperative SSI compared with traditional surveillance of all surgical patients.
Methods:A cross-sectional study was conducted among 587 patients who underwent selected general surgical procedures from January 2022 to June 2023 in a tertiary university hospital. Patients were classified as high-risk or low-risk for SSI using eight perioperative variables. Logistic regression analysis identified factors independently associated with SSI. The accuracy and agreement of selective surveillance versus traditional surveillance were assessed using sensitivity, specificity, predictive values, and Cohen’s kappa.
Results:The overall SSI rate was 12% (71/587). Independent predictors of SSI included resident service cases (OR 2.57, 95% CI 1.37–4.83), ASA score 3–5 (OR 6.28, 95% CI 3.30–11.93), clean-contaminated to dirty wounds (OR 21.73, 95% CI 6.26–75.48), operative duration beyond the 75th percentile (OR 2.33, 95% CI 1.24–4.38), and failure to maintain perioperative normothermia (OR 39.49, 95% CI 3.35–465.06). Selective surveillance demonstrated 100% sensitivity, specificity, positive predictive value, and negative predictive value, with perfect agreement with traditional surveillance (Cohen’s kappa = 1.00).
Conclusion:Selective surveillance focused on high-risk patients demonstrated excellent agreement with traditional surveillance and may serve as a cost-effective alternative for SSI monitoring in resource-limited settings. - Full text:2026071512433558818HSJ vol.15 no.1 - 1-9.pdf
