University of Twente Student Theses
The predictive value of developing surgical site infections in colorectal surgery : a comparison between the OR-cockpit grade, SSI-bundle and best model selection
Stokvis, R. (2019) The predictive value of developing surgical site infections in colorectal surgery : a comparison between the OR-cockpit grade, SSI-bundle and best model selection.
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| Abstract: | Background: Since 2016, Medisch Spectrum Twente (MST) uses the NewCompliance® OR-cockpit system, among other things, to evaluate surgeries. Based on a bundle of interventions, including: time-out, sign-out, number of door movements during surgery, preoperative hair removal, perioperative normothermia and antibiotics prophylaxis, the OR-cockpit system grades the surgeries. The main aim of this study was to examine the predictive value of the OR-cockpit grade on developing surgical site infections (SSIs) and to explore whether there is a model with a better predictive value based on other variables. Methods: A retrospective cohort design was performed in patients who underwent a colorectal surgery during the three-year period of 2016-2018 at MST. Patients were followed during a period of 30-days. Data has been collected from medical records according to the PREZIES protocol combined with standardized registered data from the OR-cockpit system. First, the OR-cockpit grade was tested on its predictive value. Thereafter, a new model, based on the bundle of interventions to reduce SSIs, was tested with multiple regression to find out if the OR-cockpit model can be improved. Univariate analysis and best subset selection were used to determine the optimum set of predictors for multiple logistic regression. Multiple regression was used to examine the predictive value of the best models on developing SSIs. The best models were compared with the model of the OR-cockpit system. Results: There were 629 patients included in this study of whom 114 patients (18.1%) developed an SSI. The predictive value of the OR cockpit grade appeared to be poor (AUC = 0.545). The new model based on the interventions did not improve (AUC = 0.570). Best model analysis showed an improved model with an AUC of 0.684. Conclusion: The OR-cockpit grade is not able to give a good prediction for developing SSIs. After best model selection and multiple regression, the model based on wound classification, ASA classification, BMI, surgical approach, surgery duration and perioperative normothermia appears to be the model with the highest predictive value in colorectal surgery. |
| Item Type: | Essay (Bachelor) |
| Faculty: | TNW: Science and Technology |
| Subject: | 02 science and culture in general, 70 social sciences in general |
| Programme: | Health Sciences BSc (56553) |
| Link to this item: | https://purl.utwente.nl/essays/78113 |
| Export this item as: | BibTeX EndNote HTML Citation Reference Manager |
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